Women come from all over the world to Chapel Hill Tubal Reversal Center for tubal reversal surgery. It is natural, and appropriate, for them to ask what their chances will be for pregnancy after a tubal reversal procedure performed by Dr. Berger. This important question about the anticipated benefit should be asked of any doctor before undergoing elective surgery. When answering questions about pregnancy after tubal reversal, we provide detailed information including pregnancy rates and their supporting data.

What Is The Success of Tubal Reversal?

There is only one way this question can be answered, and it requires ongoing follow up with patients to learn the results of their tubal reversal procedures. At Chapel Hill Tubal Reversal Center, we take this task to heart. Our nurses contact patients repeatedly during the first year after their surgery. When a patient informs us of a new pregnancy, we ask her to complete a Pregnancy Report Form. From this information, we provide a summary on the Weekly Pregnancy Reports Forum. The Weekly Pregnancy Report lists the age, date of tubal reversal, date of positive pregnancy test, method of tubal ligation, and tubal lengths after tubal repair for each pregnant woman. Additional comments about these pregnancies are shown in the Pregnancy Announcements.

Our various pregnancy information forums allow people to see the results from tubal reversal surgery performed by Dr. Berger on an current basis. The reports are not “filtered” to show only successful pregnancies. They include information about miscarriages and ectopic pregnancies as well. We want people to be fully informed about all of the possible outcomes after tubal reversal. One of our missions at Chapel Hill Tubal Reversal Center is to provide complete and accurate information about all aspects of tubal reversal surgery!

Pregnancy and Baby Testimonials

Some patients send us messages accompanied by photos after they have delivered their babies. These are spontaneous reports. Although we don’t ask patients to send us testimonials, we love receiving and reading them! They are added to the Testimonials section of our site for others to enjoy as well. Currently there are about 700 testimonial pages.

Testimonials Pages

When a patient sends us a birth announcement and photo to be added to Pregnancy and Baby Testimonials, we update an index page so that there is a link at the top of the page to the newest baby testimonial. The index page is what visitors see first when they click on any link to Testimonials. This page has brief quotes with a link to the full testimonial for each patient. We limit the index page to about 30 summaries. To see previous testimonial index pages, click the “Next” link at the bottom of the page. This will show the immediate prior group of testimonial quotes and links. Currently there are 48 testimonial index pages. To see a listing of all the testimonials, look at the Testimonials Site Map.

Our patients share so many different stories about their pregnancies and deliveries after their tubal reversal procedures. Most people don’t realize how many testimonials there are (689 as of January 13th, 2008. The testimonial number is shown in the “bread crumb” at the top left hand side of the page.) To protect patients’ privacy, only the first initial of the last name is shown. Many women include their email addresses and are happy to correspond with others about their experience here.

Pregnancy and Birth Statistics After Tubal Reversal

Since pregnancy and its outcome are the primary concerns of most women who come here for a reversal procedure, we do everything possible to obtain and report this information on an ongoing basis. This keeps us informed about the number of pregnancies and what their outcomes were after tubal reversal. It also allows us to answer questions and guide patients who are waiting to become pregnant. This takes the efforts of a dozen nurses each day, in addition to their care of patients who are preparing for and undergoing surgery. No other medical facility has undertaken this effort.

As a result of the efforts of our staff and patients, we are able to perform careful analysis and report accurate statistics regarding pregnancy rates and births rates after tubal reversal procedures performed by Dr. Berger. This is referred to as “evidence based medicine”. It is consistent with our mission, and is one of the many reasons why Chapel Hill Tubal Reversal Center has become known as the best place to have tubal reversal surgery.

Tubal ligation was intended to be permanent. Circumstances can change and women with tied tubes may want more children. When this happens, they often are told that treatment by in vitro fertilization (IVF) is their only option. In reality, tubal reversal is the best choice.

Comparing Tubal Reversal and IVF

Once the fallopian tubes are repaired by tubal reversal surgery, there is a chance every month for pregnancy to occur naturally. This is why tubal reversal is more successful than IVF.

IVF requires a woman to have weeks of hormone injections to produce many eggs each time pregnancy is attempted.  The pregnancy rate with IVF is approximately 25% per treatment cycle. Most women require multiple IVF treatments to become pregnant. At a cost of $12,000 per cycle, this treatment becomes expensive very quickly!

The overall pregnancy rate  among Dr. Berger’s tubal reversal patients is 70%, and the cost of a tubal reversal procedure is less than half that of a single IVF treatment cycle.  This graph shows that pregnancy rates are higher after tubal reversal performed by Dr. Berger than after IVF. This is true regardless of a woman’s age.

Pregnancy Rates by Age After Tubal Reversal vs IVF

Tubal Reversal IVF

Conclusion About Tubal Reversal vs IVF

Tubal reversal has a higher pregnancy rate then in vitro fertilization and is much less expensive when performed at Chapel Hill Tubal Reversal Center.

Are There Hidden Costs of Tubal Reversal?

The discounted fee when paying in full at the time you schedule tubal reversal at Chapel Hill Tubal Reversal Center is $5900. This is an all-inclusive fee. There are no hidden charges! The fee covers the following:

Preoperative record review and consultation
Dr. Berger’s surgical fee
Anesthesiologist’s and nurse anesthetist’s fees
Surgical supplies
Operating facility fees
Postoperative pain medication and antibiotics
Follow-up care

What To Expect at Chapel Hill Tubal Reversal Center

Most of our patients come to Chapel Hill from other states and from other countries. To minimize the time you spend here, your preoperative consultation will be scheduled for the day preceding your tubal reversal. On the day of your reversal procedure, you will spend the morning at Chapel Hill Tubal Reversal Center and the rest of the day at your hotel room at the Sheraton-Chapel Hill. The following morning, one of our nurses will visit you at your hotel for a postoperative check prior to your returning home. You will be here for two nights, on the day prior to surgery for your preoperative consultation and on the day of your tubal reversal procedure.

I Will Be Happy To Assist You

If you would like additional information or would like to schedule your tubal reversal procedure, please feel free to contact me. You can reach me from 8 am to 8 pm Eastern Time at (919) 656-8204 or by e-mail at JuliaS@tubal-reversal.net. I will be glad to answer any questions you might have!

Submitted by Julia Smith, RN
Nurse Administrator

If you have had your tubes tied and would like to become pregnant again, tubal reversal surgery is probably the best option for you. Tubal ligation reversal is the most successful and cost-effective way to become pregnant for 98% of women who have had a tubal ligation and now want to have another baby.

What Is Your Age?

The natural fertility rate declines with age. Pregnancy rates after tubal reversal, therefore, are highest for younger women.  Although pregnancy rates are lower for older women, you can still become pregnant after age 40 if you are ovulating and have periods.

Dr. Berger has kept detailed records of his patients and has compiled a comprehensive follow-up study on pregnancy after tubal reversal for all of his patients. His patients under 30 have a 77% pregnancy rate after having a tubal reversal procedure. The pregnancy rate is 72% for women ages 30-34 , 62% for women 35-39, and 34% for those 40 years of age and older after tubal reversal surgery performed by Dr. Berger.

What Type of Tubal Ligation Did You Have?

There are several ways that a doctor can tie a woman’s fallopian tubes. Women with the ring or clip method of tubal ligation have a 74% pregnancy rate after undergoing tubal reversal surgery. Women with the tubal coagulation technique have a 65% pregnancy rate, while women with tubal ligation and resection methods have a 62% probability for pregnancy after reversal surgery.

If you aren’t sure what type of tubal ligation you had, don’t worry! You can get a copy of your operative and pathology reports relating to your tubal ligation, and fax them to Chapel Hill Tubal Reversal Center at (919) 967-8637. Please attach the Fax Cover Sheet so we can reach you when your records arrive. Dr. Berger will review the operative report at no charge and we will contact you regarding possible outcomes for you following reversal surgery.

How To Choose The Best Tubal Reversal Doctor?

The most important question to ask is how many tubal reversal surgeries the doctor has performed. The more experience the doctor has, the better your outcome will be. Dr. Berger has the most experience with this operative procedure of any reproductive surgeon in the world and has performed more than 6,000 tubal reversals! He is considered by other medical professionals in the US and abroad to be the best tubal reversal doctor.

Also ask if the doctor performs tubal reversals on an outpatient basis. Outpatient tubal reversal reduces cost and avoids the risks of hospitalization, such as infection with hospital-acquired bacteria. Chapel Hill Tubal Reversal Center is the only center worldwide that is dedicated exclusively to outpatient tubal ligation reversal, and Dr. Berger is the only doctor who specializes in and limits his practice to outpatient tubal reversal surgery.

I Will Be Happy To Assist You

If you would like additional information or would like to schedule your tubal reversal procedure, please feel free to contact me. You can reach me from 8 am to 8 pm Eastern Time at (919) 656-8204 or by e-mail at JuliaS@tubal-reversal.net. I will be glad to answer any questions you might have!

Submitted by Julia Smith, RN
Nurse Administrator

What Is Informed Consent?

Informed consent means that a person has access to and understands all relevant information about a medical or surgical treatment necessary to make an informed decision about it. In the case of tubal ligation reversal, informed consent means that a person understands how it the surgery is performed, the alternative treatment of in vitro fertilization, and the potential benefits, risks, and likelihood of success from these treatments.

The Informed Consent Process

When meeting with patients during their consultation, I explain the outpatient tubal reversal procedure that I perform. Even before we meet at the preoperative consultation, patients review extensive information on the Chapel Hill Tubal Reversal Center website, receive printed information about the procedure, and can watch a video or dvd showing each step in the tubal reversal operation.

We also discuss the relative advantages and disadvantages of the alternative treatment of in vitro fertilization. Most important, we provide complete and accurate statistics about pregnancy rates and birth rates after the tubal reversal procedures I have performed.

Benefits and Risks

The primary benefit from tubal reversal surgery is the opportunity to become pregnant at any time in the future. It is simpler, safer, and less expensive than the alternative treatment (in vitro fertilization or IVF). The main risk associated with IVF is multiple pregnancy (33%), compared with the risk of ectopic pregnancy after tubal reversal surgery (10-15%). The medical complication of ectopic pregnancy is tubal rupture. This can be prevented by adhering to our recommended protocol for early pregnancy monitoring.

What is the Expected Success Rate?

Pregnancy and birth rates are the most important measures of success after tubal reversal for most couples. To determine what these are, a doctor must include all tubal reversal procedures and maintain follow-up with patients to learn their subsequent pregnancy histories. Since pregnancies can occur at any time, the follow-up effort and data recording must be done on a continuing basis.

Each week we provide feedback about new pregnancies reported to us via Weekly Pregnancy Reports and Pregnancy Announcements. Information about both the pregnant women and those who have not yet become pregnant is updated annually and published in our Tubal Reversal Pregnancy Study Report. The pregnancy rates and birth rates shown in this report permit prospective patients to learn the statistical probability for success, based on the experience of previous patients for whom I have performed a tubal ligation reversal.

To my knowledge, Chapel Hill Tubal Reversal Center is the only medical facility that collects, analyzes, and publishes complete and accurate statistics about the success of tubal reversal surgery based on all patients who have had the procedure performed. With this detailed information, and only this kind of information, it becomes possible to make a fully informed decision about tubal reversal surgery.

Tubal Ligation by Coagulation or Cauterization

Bipolar tubal coagulation is a popular method of female sterilization in the United States. This tubal ligation method is usually performed through laparoscopy. With the bipolar (two-poles) coagulator, the fallopian tube is grasped between two poles of electrical conducting forceps and electrical current is passed through the tube between the two ends of the forceps. Damage to the tube is limited mainly to the small segment between the forceps. Burning two or three adjacent sites is common and generally results in the loss of a few centimeters of the fallopian tube. Bipolar tubal cauterization can be successfully reversed in almost all cases.

Monopolar tubal coagulation is less common than bipolar coagulation tubal ligation. With monopolar forceps, electrical current spreads further along the length of the fallopian tube. Consequently, monopolar cautery tends to damage more of the fallopian tube than bipolar cautery. In many cases, the tube is also cut after it has been coagulated.

When monopolar coagulation is applied to a single site of the tube, tubal reversal can be performed without the need for further diagnostic tests. If multiple sites of the fallopian tube have been burned with the monopolar technique, we offer a screening diagnostic laparoscopy to evaluate the tubal lengths before proceeding to reparative surgery. The screening laparoscopy option is discussed further on our website.

Tubal Coagulation Reversal Success

Each year Chapel Hill Tubal Reversal Center publishes updated statistics about pregnancy rates and pregnancy outcomes among all of the women who have had tubal reversal procedures performed by Dr. Berger. The data for women who had tubal coagulation sterilizations, presented in the table below, are from our Tubal Reversal Pregnancy Study Report 2007.

Pregnancy Rates of Our Tubal Reversal Patients

The overall pregnancy rate after tubal reversal for women with tubal coagulation procedures is 68% for patients at Chapel Hill Tubal Reversal Center. To calculate the pregnancy rate, the number of women who have become pregnant is divided by the total number who underwent a tubal reversal procedure. The following table shows the numbers and pregnancy rates according to womens’ ages at the time of their tubal reversal surgery.

Pregnancy Rates After Tubal Coagulation Reversal

Conclusion

Tubal coagulation methods of tubal ligation can be successfully reversed in most cases. The pregnancy rate after tubal reversal varies with a woman’s age at the time she has her tubal reversal procedure. The pregnancy rate is 85% for women in their twenties, 74% for those ages 30-34, 64% for women in the 35-39 year age group, and 35% for women 40 years of age or older.

Pomeroy Technique of Tubal Ligation and Resection

The most common type of tubal ligation is the Pomeroy procedure, named after Dr. Ralph Pomeroy who described it in 1930. The Pomeroy method involves picking up a segment of the fallopian tube to create a knuckle, placing a tie or ligature with absorbable suture around its base, and then cutting off the knuckle of tube above the tie. As the suture dissolves, the 2 remaining tubal segments separate from each other.

“Modified” Pomeroy Techniques

Interestingly, Dr. Pomeroy did not publish his technique in the medical literature but simply demonstrated it to other doctors. Some of them subsequently published the technique, but with modifications.

Currently, many doctors use the term modified Pomeroy procedure when they describe the tubal ligation they have performed in a patient’s operative report. Each doctor seems to have his or her own way of operating and there are many variations from the original method. Some doctors use absorbable suture, while others use permanent sutures that do not dissolve. Some doctors place more than one tie around the tube and many doctors also burn or cauterize the tubal ends.

A tubal ligation operative report is useful as a guide but does not predict exactly what the remaining tubal segments will be at the time of a reversal procedure. Fortunately, Pomeroy tubal ligation and its modifications are usually excellent in terms of reversibility.

Pomeroy Tubal Ligation Reversal Success

At Chapel Hill Tubal Reversal Center, we keep a record of all patients’ tubal reversal operations, including the tubal ligation method, the remaining tubal segment lengths, and other important findings at the time of surgery. Since we maintain long term follow-up with our patients, we are able to provide accurate statistics about pregnancies and their outcomes after tubal reversal surgery. Here are some of the pregnancy statistics for women who have had a Pomeroy type of tubal ligation.

Pregnancy Rates of Our Tubal Reversal Patients

The overall pregnancy rate after Pomeroy tubal ligation reversal is 70% for patients at Chapel Hill Tubal Reversal Center. The table below shows pregnancy rates according to women’s ages at the time of tubal reversal. The first column shows ages by 5 year groupings. The second column shows the number of women in each age group who had a tubal reversal. The third and fourth columns show the number and the percentage of women who became pregnant after their reversal procedure. The data shown in this table come from our Tubal Reversal Pregnancy Study Report 2007.

Here is how the pregnancy rate is calculated: The number of pregnant women (column 3) divided by all women in that age category who had reversal surgery (column 2) times 100 equals the percentage of women who became pregnant (column 4). A doctor has to know all of this information in order to be able to state what the success rate is for his patients.

Pregnancy Rate By Age After Pomeroy Tubal Reversal

Good News About Pomeroy Reversal

The good news is that for women under age 40, two-thirds to four-fifths will become pregnant following a tubal reversal procedure. Even for women age 40 and over, approximately 4 out of 10 will conceive another pregnancy. From the follow-up data that we have for our tubal reversal patients, there is good reason for optimism when reversing a Pomeroy tubal ligation.

Our Tubal Reversal Center is Unique

Dr. Berger is the only physician in the country with a practice that is specifically limited to tubal reversal surgery. That is the only procedure performed here with Dr. Berger performing four reversals each day, five days a week. We have a high staff/patient ratio with one or two nurses devoted specifically to your care while you are here. All of our nurses have advanced certification in cardiac life support (ACLS) and our anesthesiologists are MDs with board certification in anesthesiology. The anesthesiologists are employees here and not anesthesia staff from another hospital or anesthesia service. In other words, everyone at Chapel Hill Tubal Reversal Center has expertise in caring for tubal reversal patients and performing reversal surgery. While you are here, you will only be with other women and couples who are here specifically for the same purpose.

We Provide Accurate Tubal Reversal Statistics

We keep detailed data and statistics on each of our patients (such as age, tube length, medical history, tube of tubal ligation, pregnancy history). This is obtained by ongoing contact with our patients to ensure we have accurate information regarding their surgery and their outcome. Dr. Berger maintains and publishes data regarding pregnancy rates and pregnancy outcomes following tubal reversal surgery. We know of no other doctor or medical facility that does this.

On the Internet, claims about tubal reversal pregnancy rates are often made without supporting information or documentation - such as a description of the patient population, study method, and follow-up interval. Most Internet sites about tubal reversal do not provide any factual data at all. Any doctor may say that his patients have a particular success rate, but supporting the claim with actual data involves considerable effort. Performing a follow-up study such as this one requires keeping an accurate record of patients and their findings, as well as maintaining ongoing patient contact to determine the outcomes of treatment. That is the only way a doctor can actually know what the pregnancy and outcome statistics are for his patients. Without this detailed type of information, the accuracy of any claim of success rates should be questioned.

At Chapel Hill Tubal Reversal Center, nurses enter information into an electronic patient database at the patient’s registration, the surgical procedure, and from regular post-operative communications with our staff. If we have not heard from patients after their recovery from surgery, our nurses contact them at 6 and 12-month intervals. We know of no other doctor, hospital, or clinic that maintains such ongoing patient follow-up records after tubal reversal surgeries. I believe Dr. Berger’s commitment to providing accurate, up-to-date data is reflected in the fact that he requires this time-consuming but important procedure to be followed so that valid information can be obtained. Each year we publish the results of our follow-up study, reflecting surgical and pregnancy outcomes. This is the most comprehensive study done to date of tubal reversal surgery and its resulting outcomes, showing that for the majority of women who have undergone a tubal ligation procedure and decide later they would like to have more children, tubal reversal surgery is a better option than in vitro fertilization (IVF).

We Follow-up With Patients and Are Always Available

Another reason to choose Dr. Berger and Chapel Hill Tubal Reversal Center is the staff! We are available 24 hours a day/7 days a week to answer questions and concerns. Patients regularly express amazement at the level of care, compassion, and professionalism that they were shown before, during, and after surgery. Patients also like the fact that they receive follow-up calls on post-op day 1 and 3 and at 2 weeks, simply to see how they were doing and to have any questions answered. Our nurses follow-up with each patient again at 6 months and one year after surgery.

Submitted by Julia Smith, R.N.
Nurse Administrator

People often wonder “If I do get the tubal reversal procedure done, what are the chances I’ll conceive?”

Dr. Berger is the only doctor who tracks his specific success rate - others doctors will just quote what has been published elsewhere or what they think the success rate should be. Dr. Berger has taken the time and the expense to meticulously keep track of his patients’ pregnancies needed to determine the success rate of the tubal reversal procedures he has performed.

Success Rates

One way to estimate your probability of success after a tubal reversal procedure is from the operative report from your tubal ligation. This can be obtained from the doctor who performed the surgery or from the medical records department of the hospital where your procedure was performed.

If you would like to forward this information to us, Dr. Berger will review the operative report at no charge and we can contact you regarding possible outcomes for you following reversal surgery. You may fax the records to us at 870-934-9211. Please include all contact information (phone and e-mail) when faxing your records.

If you have questions about your chances to get pregnant after a tubal reversal, please feel free to contact me.

Julia Smith, RN
Nurse Administrator
Chapel Hill Tubal Reversal Center
Phone: (919) 656-8204
Fax: 870-934-9211

Have you seen my tubal reversal lens on Squidoo.com? It has key information about tubal reversal. Here are some excerpts.

Tubal Reversal Success

There is just one way to know what the success after tubal reversal surgery is - and that is by documenting pregnancy and birth rates. This requires long term patient follow-up. Our ongoing follow-up system records the outcomes of every reversal procedure and provides the results for all to see. We are the only medical facility that does this! Chapel Hill Tubal Reversal Center publishes weekly pregnancy reports and pregnancy statistics that include pregnancy rates and pregnancy outcomes for my patients.

Making Surgery Comfortable for the Patient

Tubal reversal surgery traditionally has been a major operation with several days of recovery in a hospital due to postoperative pain and disability. These can be avoided.

Postoperative pain following abdominal surgery comes mainly from muscle and connective tissue injury. Abdominal retractors (metal instruments that pull back on the skin, connective tissues, and muscles) are traditionally used to give wide exposure to the pelvic organs during surgery. Pressure from abdominal retractors causes reduced blood flow to the retracted tissues, resulting in postoperative pain. The operation is best performed without retractors.

Surgical packs (large gauze pads) traditionally are placed into the abdomen to push the intestines away from the pelvic organs during surgery. Packs cause postoperative bloating due to intestinal irritation. These can be avoided also.

Injecting a local anesthetic where surgery is performed - even though the patient is asleep during the procedure - further minimizes postoperative pain. (This is called preemptive analgesia.) These are some of the ways I make tubal reversal surgery comfortable for patients. Making surgery comfortable improves recovery, avoids the need for hospitalization, and results in a low cost tubal reversal procedure.

An Excellent Reference Source

At Chapel Hill Tubal Reversal Center, we provide complete and accurate information about tubal ligation reversal. Here are some starting places:

VIP Questions
Pregnancy Testimonials
Tubal Reversal Illustrations

Tubal Reversal or IVF

Our follow-up pregnancy statistics from over 5000 tubal reversal patients show that tubal reversal is more successful than IVF. This is because once the tubes are repaired, there is a chance every month of conceiving naturally. The pregnancy rate is higher after tubal reversal than after IVF for women iof all ages. Furthermore, the cost is much less than a single IVF treatment cycle.

Pregnancy Rates After Tubal Reversal vs IVF

Tubal Reversal IVF