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.

Patient’s History

Ana G. was one of the 4 patients I operated on today at Chapel Hill Tubal Reversal Center. She is a 28 year old woman from Angola, the mother of 3 children - ages 9, 8, and 6. She married when she was 15 and was in an abusive marriage. To keep from becoming pregnant again, she had a tubal ligation. When she had this done, all she could think about was not becoming pregnant again.

Ana eventually ran away and divorced her husband. Several years later she met a man who she fell in love with and who has treated her very well. He has no children. Now remarried, Ana feels that her second husband will want children in the future, so she decided to have a tubal ligation reversal. Although she doesn’t intend to become pregnant soon, she says that if it happens that would be fine.

Ana’s Tubal Reversal Procedure

Ana’s tubal reversal was performed by the technique of tubotubal anastomosis. Her fallopian tubes were in excellent health, with no fibrosis and with normal fimbriae and tubal endothelium. The anastomoses were isthmic-ampullary on the right and isthmic-isthmic anastomosis on the left. The tubal lengths after repair were 6.5 cm on the right and 8 cm on the left side.

Dr. Berger’s Comments

Every patient who comes to Chapel Hill Tubal Reversal Center has a unique story to tell that led up to the decision for a tubal reversal procedure. Divorce and remarriage is a common theme, and a history of abuse in the prior marriage is often one of the reasons given for the divorce.

Ana’s story is unusual in that she married at age 15 and had her tubal ligation by age 21. This may be due to the cultural differences in some African countries from the US. Although most of our patients come from the United States, couples come from many other countries to have me perform their tubal reversal surgery.

Although Ana’s operative report stated that Filshie clips had been applied to her tubes, no clips were found during surgery. It is not clear whether the operative report was incorrect, or whether the clips migrated to other locations in the abdominal cavity. This can occur if the pressure from the closed clips causes necrosis or death of the tissue within the clip. I have seen this occasionally in other patients.

Predicted Outcome After Ana’s Tubal Reversal

Based on her age and tubal lengths, Ana’s probability of becoming pregnant is 90% as documented in the post tubal reversal pregnancy statistics among patients at Chapel Hill Tubal Reversal Center.

Chapel Hill Tubal Reversal Center Mission

Chapel Hill Tubal Reversal Center is the only medical facility specifically for tubal ligation reversal surgery. We provide the most detailed information about tubal reversal available from any doctor, hospital, or medical institution. This blog post describes how we are able to do this.

Electronic Patient Database

Keeping track of patients following surgery makes sense from a clinical point of view. Continuing follow-up after surgery helps ensure the best patient care. It also allows us to evaluate the success of tubal reversal surgery and the care we provide. Setting up and maintaining a system for ongoing patient follow-up is not usually found in a private medical practice. It is costly, time-consuming, and requires staff knowledgeable in database management. Despite the cost and time requirements, I have made it a priority because of my commitment to giving patients all of the information they should have to make informed decisions about tubal reversal surgery.

At Chapel Hill Tubal Reversal Center, we have a computer system where every nurse enters patient information before, during, and after tubal reversal procedures. All 11 of our nurses contact patients, record data, and make daily entries into computerized records. With this follow-up information, I can analyze and report accurate statistical data about the long-term outcomes of the tubal reversal procedures I have performed.

Information Sources

The patient follow-up system consists of information collected in many different ways and includes a minimum of 6 calls or e-mails to every patient in the first year following surgery:

1. Post-operative nurse visit the morning after surgery;
2. Telephone follow-up on the second postoperative day;
3. Telephone follow-up on the third postoperative day;
4. E-mail questionnaire at two weeks;
5. Telephone contact at 6 months;
6. Telephone contact at 12 months.

Other information is collected and recorded any time we communicate with patients post-operatively. These contacts are usually initiated by patients to report pregnancies and the outcomes of pregnancies. When patients report new pregnancies, we request that they complete a Pregnancy Report Form. Each week, we list the new pregnancy results in the Weekly Pregnancy Report Forum of the Tubal Reversal Message Board and also give more details in the Weekly Pregnancy Announcements.

Summary

After reading our information and statistics and comparing it to what might be available from other doctors, we believe patients will recognize that Chapel Hill Tubal Reversal Center is the only facility where accuracy of information is considered a priority and sharing it with prospective patients is considered a necessity. Providing facts, rather than offering misleading or speculative statements about tubal reversal success, is one mission of our practice. We believe this is the right thing to do.