Tubal Reversal Blog ‘tubal ligation reversal’

In the Fall of 2008, I was preparing to meet with a patient who was traveling to Chapel Hill Tubal Reversal Center from Fort Campbell, Kentucky (KY) for a tubal ligation reversal. The patient’s name was Catrina. She is 33 years old and newly married to, Chris, an Army Staff Sergeant.

Catrina sent us an operative report from a diagnostic laparoscopy (camera surgery), that discovered she had a tubal ligation. During our interview, I asked her why her general gynecologist had done this surgery. I was surprised by the story she had to tell.

Catrina’s Story

“On January 30th, 1998, I had a tubal ligation without my consent. I was having my daughter by by C-section  and, while I was under general anesthesia, my ex-husband told the doctor he no longer wanted to have children. My ex-husband signed the tubal ligation consent papers. Without either my consent or knowledge, the doctor tied my tubes. I was never informed of this procedure.

My marriage was abusive and did not work out for many painful reasons: I now will fast-forward about 7 years.

I meet Chris and we could not figure out why we were not getting pregnant. There was nothing wrong with him and, I thought, nothing was wrong with me. I went to my gynecologist to be evaluated for infertility. I had a hysterosalpingogram x-ray (HSG). The HSG showed my tubes were blocked.

Of course, I was wondering why in the heck my tubes were blocked. The doctor suggested we have a diagnostic laparoscopy to evaluate why my tubes were blocked. After I awoke from surgery, he told me my tubes were blocked because I had previous tubal ligation. I was stunned. I thought these kinds of things did not happen here in the United States! You mostly hear about these stories in third world countries.

After I got over the shock and denial, I started researching how I could have a baby after a tubal ligation. I had just about all but given up hope when a friend told me about Chapel Hill Tubal Reversal Center. After some research into tubal ligation reversal, I was excited and decided to have a tubal reversal. Apprehensive but excited!

On Oct 15 2008, Dr. Monteith and his wonderful tubal reversal team gave me back my life and my dream of having a ton of kids! If I had never gone to see Dr. Monteith, then I do not know what I would have done! In just ten days after surgery, I felt like I had not felt in years. I was so much happier and had so much more energy. Amazingly, everything even looked and smelled better. I felt like I had been reborn.”

Pregnant After Tubal Reversal

We were extremely excited to hear Catrina became pregnant within two weeks of her tubal ligation reversal surgery. Unfortunately while writing this article, Catrina notified us she had a miscarriage and is now physically and emotionally recovering from this event. Since Catrina is not a regular Tubal Reversal Message Board user, we invite readers to leave comments for her on this blog posting.

By Dr. Charles Monteith

The tubal reversal doctors at  Chapel Hill Tubal Reversal Center are specialists in fallopian tube repair.  Although most of patients come to Chapel Hill Tubal Reversal Center for tubal ligation reversal, others come for fallopian tube repair after a tubal infection or pelvic inflammatory disease (PID), ectopic pregnancy, or previous surgery involving the fallopian tubes.

Fallopian Tube Anatomy

The fallopian tube begins within the muscular wall of the uterus (interstitial segment), leads away from the uterine wall (isthmic segment), becomes wider (ampulla), extends to the widest area near the end of the tube (infundibulum), and ends next to the ovary (fimbrial segment).

The fallopian tube has several important functions that include:

• Capturing the egg at ovulation
• Providing the proper environment for fertilization
• Transporting the fertilized egg to the uterine cavity

When fallopian tubes have become damaged, pregnancy difficult and sometimes impossible to achieve.

Fallopian Tube Disease

When a fallopian tube is damaged and completely closed, sperm cannot reach an egg to fertilize it, and the egg cannot reach the uterine cavity. Common causes of fallopian tube damage are:

• Pelvic inflammatory disease (PID)
• Other abdominal infections
• Ectopic pregnancy
• Prior pelvic surgery

Diagnosing Fallopian Tube Disorders

The possibility of fallopian tube damage should be suspected when a woman is either unable to become pregnant or has a history of multiple ectopic pregnancies. The diagnosis of a damaged fallopian tube usually is made from an x-ray procedure called a hysterosalpingogram (HSG). During an HSG, a radio-opaque dye is placed into the cavity of the uterus and pictures are taken as the dye flows into the fallopian tube. If the dye does not travel freely from the uterine cavity and through the fallopian tube into the abdominal cavity, then fallopian tube damage is suspected.

Fallopian Tube Repair

Fallopian tube damage due to infection of the tube may result in a swollen, club-shaped tube called a hydrosalpinx. In this situation, the fimbrial end of the tube is closed by scar tissue. This is easily diagnosed by a HSG when the dye is seen to fill the fallopian tube but becomes trapped within it at its swollen fimbrial end. This is the most common type of tubal disease that results in patients seeking fallopian tube repair.

Repairing Hydrosalpinx

A hydrosalpinx can be repaired by the technique of microsurgical salpingostomy. In this procedure, the fimbrial end of the fallopian tube is opened and folded back where it is sutured in place to keep the tube open. Any scar tissue responsible for closing the end of the tube is removed. Pregnancy success rates after microsurgical salpingostomy are approximately 40%. There is an increased risk of ectopic pregnancy after repair of a hydrosalpinx, particularly if the internal lining of the tube has been damaged extensively. It is the internal lining, rich in cilia, that help move the egg down the tube to arrive in the uterine cavity.

Fallopian Tube Repair at Chapel Hill Tubal Reversal Center

The tubal reversal doctors at Chapel Hill Tubal Reversal Center, Dr. Gary Berger and Dr. Charles Monteith, are reproductive surgeons who are specialists in tubal ligation reversal and fallopian tube repair. They perform more than 800 tubal reparative surgeries each year for women from thoughout the United States and around the world. Their vast experience in repairing fallopian tubes allows women with fallopian tube damage to become pregnant naturally as opposed to  the more expensive and complicated treatment of in vitro fertilization.

More Information on Fallopian Tube Repair

Tubal ligation is a surgical procedure that blocks the fallopian tubes to prevent pregnancy. Many people commonly refer to tubal sterilization as having their ‘tubes tied’. The more correct medical term is tubal occlusion (occluding or closing the tube), because not every fallopian tube is ligated or tied when it is closed. There are many different ways to perform a tubal ligation, but all the procedures cause some destruction of the fallopian tubes. There are many ways to perform a tubal ligation: tying and cutting, cauterizing (burning) and clipping or banding the fallopian tubes are the most common techniques.

Tubal Ligation: A Common Surgical Procedure

Tubal ligation is a very common surgical procedure in the United States. The Center for Disease Control (CDC) and Prevention investigated surgical sterilization in 1995 and discovered 10.6 million women in the US had a tubal ligation procedure. Tubal ligation was twice as common as vasectomy. The study also found 1 out of 4 women desired a tubal ligation reversal at some point in their lives.

Tubal Ligation Reversal

A large number of women will regret their decision to have a tubal ligation and want to have another baby. According to the CDC study of 1995, more than 2.5 million women in the US will want to have their ‘tubes untied’. Many of these women are unaware that tubal ligation reversal exists, or they may be told that treatment by in vitro fertilization (IVF) is their only option. Most of these women will abandon hope of becoming pregnant again.

Untying Fallopian Tubes

Just as the expression of having the ‘fallopian tubes tied’ is commonly misused,  the description of ‘untying your fallopian tubes’ has also become a frequently used, but inaccurate description of what actually occurs during tubal surgery to repair blocked tubes. More accurate terms for this type of surgery are tubal ligation reversal or tubal reversal. There are several ways to repair fallopian tubes after a sterilization procedure. Tubotubal anastamosis is the most common technique for performing tubal ligation reversal surgery. These illustrations show the method of tubotubal anastomosis (also called tubal anastomosis or tubal reanastomosis).

Tubal ligation involves closing the fallopian tubes by destroying a portion of the fallopian tube, which causes the tube to heal closed. Tubal ligation reversal involves opening and rejoining the closed ends of the fallopian tubes. This procedure is done under magnification using microsurgical techniques and is very successful in allowing women to become pregnant. When performed by the tubal reversal doctors at Chapel Hill Tubal Reversal Center,  70% of women will become pregnant after a tubal ligation reversal.

Tubal Reversal Cost

We provide affordable tubal reversals at Chapel Hill Tubal Reversal Center. We specialize in outpatient microsurgical tubal ligation reversal. We annually perform over 800 reversal surgeries every year and patients travel from across the United States and the world to have tubal ligation reversal at our center. We have developed special techniques to allow tubal reversal surgery to be affordable, safe, and highly effective. Our tubal reversal pregnancy rates, tubal reversal pregnancy testimonials, and patient satisfaction messages are testaments to our leadership in the field of tubal ligation reversal surgery.

Reversing Tubal Sterilization

Tubal ligation reversal at Chapel Hill Tubal Reversal Center is a simple and safe outpatient operation for reversing tubal sterilization through a small incision that results in minimal discomfort and recovery time.

Dr. Gary Berger and Dr. Charles Monteith specialize in untying tubes. Women travel to Chapel Hill, NC from all over the United States and other parts of the world to have their tubes repaired after a previous tubal ligation. Over 7000 women have chosen to come here for their reversal procedures because we specialize exclusively in tubal ligation reversal, have perfected the outpatient approach to reversal surgery, and have the best success in terms of pregnancies after tubal reversal surgery.

Reversal Surgery Through a Small Incision

Patients often ask about the size and location of the incision for untying the tubes. The incision is about 2 to 3 inches in length at top of the pubic hair line similar to a “Bikini incision”. This incision is about one-third the length of an average C-section incision. In thin patients, it is not much wider than a quarter. It is sufficient, however, to be able to repair the tubes successfully. This type of incision results in the least amount of pain after reversal surgery and the fastest recovery time. Heavier patients, or those who have had multiple abdominal operations, may require longer incisions.

Reducing Postoperative Pain

Factors that cause postoperative pain are:

Length and location of the surgical incision
Using retractors to expose the pelvic organs
Using packs to push away the intestines

Our surgical techniques minimize postoperative pain. We use a small, transverse (cross wise) bikini line incision. We avoid routinely using retractors and packs. Patients at Chapel Hill Tubal Reversal Center are much more comfortable than after standard abdominal surgery. This avoids the high cost of having to recover in a hospital.

Pride in Our Tubal Reversal Mission

The tubal reversal doctors at Chapel Hill Tubal Reversal Center specialize exclusively in repairing fallopian tubes. What do we mean when way say this?

We do not talk patients into in vitro fertilization (IVF).
We make tubal reversal affordable.
We provide ongoing postoperative follow-up.
We have the best results leading to pregnancy.

As tubal reversal specialists, we provide a safe and comfortable outpatient approach for reversing tied tubes. This makes tubal ligation reversal the best option for women who want to have more children or who simply want their bodies restored to normal after a surgical sterilization.

We take great pride in making tubal ligation safe and affordable for women throughout the world.

Tubal Reanastomosis | From Ireland to Chapel Hill

Tubal reanastomosis has become an international patient care issue. This is the story of Paula O., who came from Ireland to Chapel Hill Tubal Reversal Center to have Dr. Berger perform her tubal reanastomosis.

Paula and her husband, Raymond, each have children from previous marriages, but they want to have a child of their own. Paula is a 41-year-old psychiatric nurse whose tubal ligation performed several years ago was by an unknown method. After doing extensive research about both IVF and tubal reversal surgery, they decided to travel to Chapel Hill, North Carolina to have the best tubal reversal doctor repair Paula’s fallopian tubes.

IVF vs. Tubal Reanastomosis

Paula and Raymond started their research last year about the treatment options for becoming pregnant after a tubal ligation. Her general practitioner advised treatment by IVF and discouraged her from pursuing tubal ligation reversal. Investigating IVF in Ireland, she found that waiting list was long and the cost was 15,000 Euros (20,500 US dollars). They learned that IVF in Holland was much less expensive at 7,000 Euros (9,500 US dollars) for a treatment cycle.

Paula felt pressured by time constraints and her age. European IVF doctors would not perform IVF once she reached the age of 42 (not even with donor eggs). The concept of subjecting her body to the large doses of hormones required for IVF was unappealing to her. Gradually, she became disenchanted with the concept of IVF.

When she began researching the alternative of having her tubes untied, she read about the high success and low cost of tubal reanastomosis at Chapel Hill Tubal Reversal Center, in Chapel Hill, North Carolina. Paula and Raymond were both impressed with the web site, patient information, pregnancy statistics and doctor’s credentials at Chapel Hill Tubal Reversal Center. They also learned about some European doctors who could perform tubal reversal surgery, but these doctors had nowhere near the experience of Dr. Berger, and the cost of tubal ligation reversal in Europe was about 15,000 Euros (20,500 US dollars).

Tubal Reanastomosis in the U.S.| Their Best Choice

Paula and Raymond decided to travel to the US for her tubal reversal procedure. They purchased airline tickets for 900 Euros each (1200 US dollars) and flew to Raleigh Durham International (RDU) by way or Newark, NJ. Including layover time, the flight from Ireland was only 9 hours.

They met with Dr. Berger the day before surgery for her preoperative consultation. Because of the uncertainty about the type and extent of her tubal sterilization, Paula elected to begin her reversal procedure with screening laparoscopy. Dr. Berger performed Paula’s surgery with Dr. Monteith assisting him. Her laparoscopy revealed healthy fallopian tube segments that could be repaired. Tubal reanastomosis, therefore, was immediately performed while she was under anesthesia. The length of each fallopian tube was 6.5 cm after her tubal repair.

Tubal Reversal Cost with International Travel

Paula’s tubal reversal cost was 4591Euros ($5900 US dollars). The total cost of Paula’s entire surgery was slightly higher (5370 Euros or $6900 US) because she chose the screening laparoscopy option since the type of tubal ligation was unknown. Even with the cost of international travel and optional laparoscopy, Paula’s reversal surgery was far less costly than the average cost of tubal reversal in Europe (15,000 Euros).

Paula recovered quickly after having her tubes untied. She and Raymond walked around Chapel Hill the day after having her tubes untied. On the following day, they came back to Chapel Hill Tubal Reversal Center and gave a very delightful interview for the Tubal Reversal Blog.

Tubal Ligation Reversal Gave Paula Control

During their return visit to our office, they made these comments:

Paula felt that IVF gave too much control and decision making over her body to another person. She did not want someone else deciding she could not be a mother simply because she reached the age of 42. Tubal ligation reversal gave her back control over her own body.

Raymond felt that tubal reanastomosis was a much better treatment for them than IVF would have been.

They both commented about how the staff at Chapel Hill Tubal Reversal Center treated them like family from the moment they arrived. They were impressed how nice and comforting the environment was at Chapel Hill Tubal Reversal Center, especially when compared to the medical facilities they had been to in Ireland. In fact, they enjoyed their stay here so much they are considering relocating to North Carolina because the cost of living and the weather is far better here than compared with Ireland.

Home Safely in Ireland

Here is the patient satisfaction message Paula sent to Dr. Berger upon arriving home in Limerick, Ireland:

Greetings to Dr. Berger from Ireland!

We have arrived home safely and feeling great. Thank you so much for the wonderful care and attention that you and your wonderful staff gave me while in your care at your Clinic. I am so happy that I made the decision to come all the way from Ireland to Chapel Hill Tubal Reversal Center for my reversal surgery. The whole experience was such a positive one and we met many people on our journey home that I shared this experience with regarding the quality of care that I received during the whole procedure.

May God Bless you, Dr Berger.

Kind Regards,

Paula and Raymond B.
paulabeaulieu67@hotmail.com

This article profiles a patient who came to Chapel Hill Tubal Reversal Center for reversing tubal ligation at which time she was found to have ovarian endometriosis.

Travel from California

The patient and her husband traveled from Monterrey, California for tubal ligation reversal. She is 44 years old and is a banker. She has two children from previous marriage, ages 12 and 15. Her husband is a meteorologist. He has two children from a previous marriage, ages 16 and 18. They moved from Texas to California and have been married together for 1 year and 3 months. Together, they desire a child of their own.

IVF Evaluation

Prior to traveling to visit us, they had a consultation with a reproductive endocrinologist near where they live. They expressed dissatisfaction with their consultation because they felt the doctor only wanted to offer them in-vitro fertilization (IVF). They did consider IVF but decided the procedure was not for them. During the preoperative consultation they specifically stated:

“We wanted to have a baby as God intended it.”

They did their own search for tubal reversal doctors and chose to come to Chapel Hill Tubal Reversal Center because we specialize exclusively in reversing tubal ligation. They felt their chance for a successful reversal procedure would be best at our center.

Preoperative Evaluation and Surgery

She was a healthy person and denied any known preexisting problems or menstrual abnormalities.  We reviewed her tubal ligation operative and pathology reports that described at least 3 cm removed from each fallopian tube. We discussed their expectations and the risks and benefits of tubal reparative surgery.

During her surgical procedure and upon entering the abdominal cavity, we discovered brown fluid suggesting the presence of endometriosis. Close inspection of the right ovary revealed endometriosis inside of it and partially involving the right tube.

We removed the endometriosis and repaired the right tube. The left tube and ovary were normal. The left tube was repaired without difficulty.

She did well during the surgery. In the recovery room, we informed her and her husband of the unexpected endometriosis and the successful repair of both fallopian tubes.

Endometriosis

Endometriosis can be suspected in most patients based on a careful evaluation of a menstrual history. Many women with endometriosis will have extremely painful menstrual periods. Menstruation can be so painful patients may require large amounts of pain medications, miss time from work, or will have pelvic pain which drastically affects their  personal lives. Many women give a history of severe pelvic pain, especially with intercourse and will plan their sexual activity based on their menstrual cycles. Many patients, like this one, can have minimal or no symptoms of endometriosis.

We could not have predicted this patient’s endometriosis in advance because of her absence of preexisting symptoms. Fortunately, we were able to successfully reverse her tubal ligation and remove the endometriosis at the same time.

We wish her well on her trip back to Monterrey California and hope a healthy pregnancy will be in her near future.

At the age of 32, Rebecca underwent a tubal ligation in 1995. Within one year, she began to notice worsening menstrual symptoms which were attributed to Post Tubal Ligation Syndrome (PTLS). She dealt with these symptoms for 12 years before deciding to undergo tubal ligation reversal surgery.

Her story prior to tubal ligation reversal can be read in the article entitled Meet Rebecca. Rebecca reported her symptoms after tubal ligation as:

Loss of libido
Losing more that the normal amount of hair daily
Unexplained Weight gain
Loss of sexual arousal
Loss of natural lubrication
Painful intercourse
Depression
Isolation
Spotting
Heavier cycles
Unexplained Joint pain
Migraine headaches
Severe Mood Swings
Severe Temperature fluctuations

Rebecca’s Tubal Reversal Surgery

Rebecca underwent an outpatient tubal ligation reversal in July 2008. Drs Berger and Monteith performed her surgery. Rebecca’s fallopian tubes were found to be in good condition and she had a successful bilateral, microsurgical tubotubal anastamosis. Her surgery lasted 88 minutes. She was subsequently released to the local Sheraton hotel, was seen the next day by a Chapel Hill Tubal Reversal Center staff member, and was then discharged to home. She has recovered from reversal surgery without any complications.

Rebecca After Surgery

Rebecca’s report on her symptoms since having reversal surgery:

As far as my symptoms at this point:
I believe it is too early to really notice any changes but here are the few that I am aware of this month.
I am thinking about intimacy once again and I feel that my libido is coming back.
Intercourse was not painful.
My headache this month lasted only one day.
My moods are still erratic and my hair continues to fall out.
I plan to keep track of my feelings, including the desire for intimacy, and sexual arousal signs; in addition to other symptoms.
I believe hormone testing is important before and after a tubal reversal. Perhaps every 3 to 6 months along with keeping a journal of menstrual symptoms.

CHTRC Series of Worsening Menstrual Problems After Tubal Ligation

This is the twelfth article in our fourteen part series on PTLS and associated medical conditions. Our first article, Pain After Tubes Tied: Symptom of Post Tubal Ligation Syndrome?, reviews symptoms associated with PTLS.

Our next several articles will continue to present patients who have suffered from worsening menstrual, physical, and emotional symptoms after surgical sterilization procedures ( women who had their tubes tied).

Readers can also view other patient submitted stories about their menstrual symptoms, reasons for reversing tubal ligation, and outcomes after reversal reversal surgery. Each patient’s story is listed below:

Meet Momzilla
Meet Andrea
Meet Praybelieving
Meet Katherine

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.

Rebecca’s experience with Post Tubal Ligation Syndrome in her own words…

My name is Rebecca and I am 45 years old. My husband’s name is Dana and he is 47.

I have a BA in Elementary Education. After teaching, I chose to stay at home the past twelve years with my daughter. I have home schooled her for the past 7 years. At the present time, I design and sew costumes for ballets and other performances.

My husband has a BS in Industrial Engineering. He works for a non-profit organization. He works as a liaison between the government and manufacturers that hire individuals with disabilities, in particular those who are blind.

We have been married for 26 years. We have four children. Two sons, ages 25 and 22 and two daughters ages 23 and 12. We have a grandson (4) and granddaughter (2) by our daughter, who is married to a wonderful man.

I had the tubal ligation in 1995 after the birth of my daughter. Just prior to this pregnancy I had a miscarriage. This put a scare into my husband. It was a pretty nasty miscarriage and although the next pregnancy was fine, he was concerned for my health and future pregnancy’s in addition to the age factor. I had my daughter at the age of 32. I did regret the tubal ligation. I felt I had interfered with God’s plan for my life. However, this I had come to terms with.

I found Chapel Hill Tubal Reversal Center in 1999. However, I did not read the message boards because I thought it was selfish of me to even think of spending that kind of money (for reversal surgery). The thought of a tubal ligation reversal went to bottom of the priority list. Life went on for the next 12 years. I finally began reading the boards and realized how many other women had suffered what I had and that there was hope by having a reversal.

I was approximately 33 when the symptoms of Post Tubal Ligation Syndrome (PTLS) began to show up. It is only after researching PTLS and reading my journals I realized my symptoms were very similar and often times identical to many other women out there. When the symptoms did show up I did not realize what the “condition was”. I thought what I was going through was part of the aging process.

The first thing to go was the desire for intimacy. This included a diversion to intercourse. I was unable to produce any signs of arousal, including cervical mucus. Intercourse became painful and had never been so before.

Doctors told me I had endometriosis, when in fact I did not.They also told me it was because of my tipped uterus. Not so. A tipped uterus has nothing to do with arousal. I told myself it was age, and the fact that I had born four children.

My moods became very erratic. I would blow up at the least little thing. Then moments later I would be fine. I would get depressed and have no desire to be around people.

This was not me; I love interaction and being around people. The saddest part about the erratic mood swings was the very real possibility that my husband may get fed up with me and all we had would be lost. It felt as if I had no control over my emotional state of mind, as if my world was crumbling and the only way to fix it was to take anti-depressants. This was not an option for me.

I began to get migraine headaches prior to my menstrual flow.

Severe headaches. They would last up to four to five days. I had never had headaches. My hair began to fall out. That began happening almost immediately. Again I thought that was normal.

Although I was very active, I began to put on weight around the age of 35. I began to get night sweats. One moment I would be cold then sweating profusely. My joints began to ache. I got unexplained joint pain. I was even diagnosed with tendinitis at the age of 35 (I do not play tennis). My doctor could not figure this out.

My menstrual cycle stayed at 28-day cycles, lasting about 7 days. Typically 3 days heavy 4 days light. However, they also began to be much heavier for longer than 3 days, and I began to experience spot bleeding. I would believe my cycle was over and then I would begin to bleed again about 3 days past my cycle. I didn’t say anything to the doctor; I was too concerned he would say I needed a “hysterectomy“. Or they would tell me that I was preparing to go into menopause. My friends even had me convinced that I was in the early stages of menopause.

I had been told for so long that everything that was happening to me was because of early menopause; I have a tendency to question if PTLS is real. That is why when I read the stories on CHTRC’s message boards about PTLS; I came to realize it is real…

Rebecca’s after surgery story can be viewed on the following blog article entitled Rebecca After Tubal Ligation Reversal.

CHTRC Series of Worsening Menstrual Problems After Tubal Ligation

This is the eleventh article in our fourteen part series on PTLS and associated medical conditions. Our first article, Pain After Tubes Tied: Symptom of Post Tubal Ligation Syndrome?, reviews symptoms associated with PTLS.

Our next several articles will continue to present 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.

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.

Post Tubal Ligation Syndrome Series

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.

Some women will develop problems after a tubal ligation procedure. Many will attribute these symptoms to Post Tubal Ligation Syndrome (PTLS) and will consider sterilization reversal. Some of these women will not have PTLS but, instead will have other underlying  medical conditions.

We started this series of articles for women suffering from adverse symptoms developed after a tubal ligation. We discussed the symptoms of Post Tubal Ligation Syndrome (PTLS), current medical studies about PTLS, and common medical conditions that can closely mimic PTLS. Like a long bus ride, we have expected most passengers to have exited this bus trip at each of their respective and appropriate stops after a thorough evaluation of the possible causes of their symptoms. If passengers are still riding, then the only stop left is PTLS.

In the past, the existence of PTLS has been widely debated but not agreed upon in various medical studies. The largest study to date, the CREST study, found no significant difference in the percentage of women with menstrual problems after a tubal ligation with a “control” group of women who did not have a tubal ligation. The authors of the CREST study concluded that adverse symptoms do not ocurr as a  result of tubal ligation. This study, however, was not designed to study the multitude of symptoms that women report after surgical sterilization.

The end of the journey

Our experience at Chapel Hill Tubal Reversal Center suggests PTLS does exist for a select group of women for whom no contributing medical, psychological, or other causes have been identified. Among this group of women, the vast majority have reported dramatic improvement in their symptoms after a reversal of their tubal ligation.

We will report the stories of several of our patients (both before and after tubal ligation reversal) who have had worsening physical and psychological conditions after sterilization and who have come to us seeking tubal ligation reversal. They will share with us their symptoms and how they have fared after tubal ligation reversal (had their tubes untied).

This is the sixth article in our fourteen part series on PTLS and associated medical conditions. Our next several articles will present patients who have suffered from worsening menstrual, physical, and emotional symptoms after surgical sterilization procedures (women who had their tubes tied).

Readers can also view patient submitted stories about their menstrual symptoms, reasons for reversing tubal ligation, and outcomes after reversal reversal surgery. Each patient’s story is listed below:

Meet Momzilla
Meet Andrea
Meet Rebecca
Meet Praybelieving
Meet Katherine

Visitors may join the PTLS Forum on the Tubal Reversal Message Board to share their experiences of symptoms after tubal ligation procedures and what happened to them after a tubal reversal.