Tubal ligation reversal is very successful at allowing women who have had their tubes tied to become pregnant again. In general, 70% of women who have their tubes untied at Chapel Hill Tubal Reversal Center become pregnant after reversal of tubal ligation. This overall statistic is based on all patients, but there is variation depending upon an individual’s age and method of tubal ligation.
My name is Andrea, and I’m a 31 year-old home schooling mother to four children.
I’m married to my partner in Christ, Jeff, who is 36. Jeff has his own CPA practice here near our home. We live in beautiful Coeur d’ Alene Idaho, where we are a very close knit Christian family.
In 2005, against the advice of my doctor and with my husband cautioning against it, I had a Filshie clip tubal ligation at the planned c-section birth of my daughter. My doctor used clips because of my age at the time of tubal ligation, as well as the fact that he believed I would want more kids based on my nature.
Soon after the birth of my daughter, I began experiencing symptoms that independently wouldn’t have been alarming, but when gathered together, had me very worried and feeling terrible. Early after the birth, I felt very sad about not having more children. At times I thought the symptoms were just because I was sad about ending my fertility. Now I know they are separate, as well as the desire to continue to have more children, even if you already have “more than normal”, is a God given desire, and NOT something BAD.As my symptoms began to mount, I began a journal of NEW symptoms for me. While one or two of these may not be abnormal, each one of these was new for me, and together made a host of symptoms.
· Period returned 3 weeks after post-partum bleeding, despite breastfeeding full time. The earliest I had a period while breastfeeding before was 8 months!
· Cyclical migraines or cluster headaches. Typically, one in the week before my period, one upon my period leaving, and one mid-cycle. Each took up to 4 days to clear completely, and each required prescription medication. Nausea and vomiting would accompany without treatment.
· First time I couldn’t lose my baby weight through breastfeeding, diet and exercise.
· Highly emotional, and easily brought to tears or sadness.
· Extremely dry skin.
· Mid-cycle cramping and breast tenderness.
· Terrible cramping for 1-2 days of menstruation, with moderate cramping before bleeding starts, with light cramping entire period. I’m a very active woman with high pain tolerance. This cramping was enough to nearly bring me to tears.
· Bleeding so severely, I would soak a pad in an hour. My doctor suspected menstrual anemia.
· Bleeding sometimes mid-cycle. Spotting would begin on CD 23-24 and continue through 28 when heavy period would start. Bleeding would last 7 full days, with spotting another 2-3 at the end.
· Persistent yeast infections, presumably from being “damp” due to having to wear pads much of the month to catch unexpected flow.
When looking at this journal, I sought the advice of my OB/Gyn and family physician. Both doctors acknowledged tubal ligation can and often does cause painful and heavy periods. However, my family physician went a step further. She conveyed that she had heard numerous cases of women having severe problems following tubal ligation, and was fully on board in my seeking a reversal. She did hormone screening and other blood work, and my OB/Gyn performed a pelvic ultrasound to rule out endometriosis, infections, fibroids, cancers and cysts. Both doctors gave me a clean bill of health, with no other cause for my new problems. Both doctors wrote to my insurance company, requesting payment for a tubal reversal on the sole basis of Post Tubal Ligation Syndrome (PTLS).
The insurance company, a national and well-known provider, wrote back these words:
“Although a tubal ligation reversal is medically necessary for the health of the insured, tubal reversals are not covered as the code falls under fertility treatment which is excluded. *Named insurance company* will authorize payment for treatments of hormone therapy, ablation, D&C and hysterectomy.”
Obviously, at 29 years old and also seriously mourning the loss of my fertility, these were not acceptable treatments for the physical manifestations of my tubal ligation.
We began the process of searching out the best doctor to perform a tubal ligation reversal, and saving the funds to do so. Some local physician’s, including my own, perform tubal ligation reversal. However, I was unable to feel satisfied about the outcome since none maintained accurate PTLS relief and pregnancy statistics based on their own work. Doctor’s in the Seattle area also do tubal ligation reversal, as well as many other cities in the nation. The local doctor’s were going to cost us about $12,000. Even with travel from Northern Idaho, Chapel Hill Tubal Reversal Center was a more affordable, and a more highly skilled facility.
This is the ninth article in our fourteen part series on PTLS and associated medical conditions. The first article, Pain After Tubes Tied: A Symptom of Post Tubal Ligation Syndrome?, introduces the most common symptoms some women attribute to their tubal ligation.
Readers can also read Andrea’s after surgery follow-up story: Andrea After Tubal Ligation Reversal Surgery. In addition to telling us how she has done after her tubal ligation reversal, she also has some exciting news to share!
Our next several articles will present personal stories of some of our patients who have suffered from worsening menstrual, physical, and emotional symptoms after surgical sterilization procedures ( women who had their tubes tied).
We invite readers to join our Tubal Reversal Message board and discuss and share personal experiences with tubal ligation. We also have a dedicated PTLS forum for readers to share experiences of worsening symptoms after tubal ligation procedures.
Tubal reversal information is plentiful on the internet, but not everything that you read is accurate or factual. Of the websites that provide information about tubal ligation reversal, the one from Chapel Hill Tubal Reversal Center is most complete and accurate. It describes the various types of tubal ligation procedures and the different tubal reversal procedures that can be used. If you are interested in learning about tubal reversal, spend some time looking at the different pages on this extensive site. There is a search box at the top of every page that can direct you to specific information about any issues relating to tubal ligation reversal. Take a look also through the many topics of information on the Tubal Reversal Blog.
Tubal ligation reversal is usually considered to be a major operation, taking several hours and requiring a hospital stay of 1 to 5 days. Complete recovery is often described as taking 4 to 6 weeks. However, the tubal reversal procedure that Dr. Berger has developed is performed as outpatient surgery with no hospital stay required and with complete recovery generally within 5 to 10 days. Since hospitalization is not required, the cost of the tubal reversal procedure is reduced by half or two-thirds of the cost when performed in a hospital. Patients are more comfortable during their post operative recovery and are able to return to work and other normal activities much faster. A free video or DVD of Dr. Berger’s tubal reversal procedure is available on the Chapel Hill Tubal Reversal Center website.
As with any surgery, complications are always a possibility. Although rare, these may include bleeding, infection, damage to other organs, or complications of anesthesia. The most significant risk associated with tubal ligation reversal is the long term risk of having an ectopic pregnancy. This risk is increased from approximately 2% of pregnancies in the general population to approximately 10% after tubal reversal. Fortunately, the medical problem of a ruptured tubal pregnancy can be prevented by following an early pregnancy monitoring protocol that has been described by Dr. Berger and is recommended to all women after a tubal reversal procedure.
Rather than “untying” their tubes, some women are advised to be treated by in vitro fertilization (IVF). However, IVF is more complicated and expensive, the pregnancy rate after IVF is not as high as after tubal reversal, and there is a very high incidence of multiple births (approximately 30%) after IVF. Further, there is concern about the possible long term effect of the use of potent hormones to stimulate the ovaries to produce many eggs (called “super-ovulation”) and the suspicion that it might increase the risk of ovarian cancer later in life.
Although most women have been told that tubal ligation is permanent, in fact, the vast majority of tubal ligation procedures are reversible. The operative report from your tubal ligation will give a good indication if the procedure can be reversed. When there is any doubt about this, diagnostic laparoscopy can be performed to examine the fallopian tubes and then decide whether to proceed with the reversal operation.
Pregnancy and birth rates after a tubal reversal are significantly better than after IVF. Neither procedure, however, can guarantee that pregnancy leading to birth will occur. Even when the fallopian tubes have been repaired, other factors – such as age, menstrual cycle regularity, ovulation or other hormonal disorders, and the fertility of the male partner – may determine when, or whether, conception will occur.
Women under the age of 30 who have a tubal reversal have an 82% pregnancy success rate; between 30-34 the pregnancy rate is 76% and for women ages 35-39, the pregnancy rate is 67%. The pregnancy rate declines for women 40 and older in accordance with the natural decline in fertility with age. However, pregnancy rates are higher for women of any age following tubal reversal than after IVF.
If you would like to discuss your individual situation with a Tubal Reversal Nurse, call (919) 968-4656. The experienced nurses at Chapel Hill Tubal Reversal Center are always happy to provide information about tubal ligation reversal. You can also exchange information with other women on the Tubal Reversal Message Board.
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Gary S. Berger, M.D. |
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Charles Monteith, M.D. |
Tubal Ligation Reversal News
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