Desire for Tubal Ligation Reversal
Gary S. Berger, M.D.
Female sterilization in the US
Female sterilization is the second most frequent birth control method in the United States, chosen by over 10 million women. Approximately 650,000 female sterilizations are performed in the US each year. This means that about one in every four American women using contraception have had a sterilization operation. Although most women remain satisfied with their decision to have a tubal ligation, many express regret and desire to reverse the procedure.
In a study called the U.S. Collaborative Review of Sterilization, women were interviewed each year for 5 years after they underwent a tubal ligation. A final interview was conducted 8-14 years after the sterilization operation. The following question was asked at each interview. "Do you still think tubal sterilization as a permanent method of birth control was a good choice for you?" Overall, 13% of women said they did not think that the tubal ligation was a good choice. The percentage expressing regret was 20% for women aged 30 years or younger at the time of sterilization, compared with 6% for women older than 30 years at the time of tubal ligation. For women under age 25, the rate was as high as 40%. The regret rate was also high for women who were not married at the time of their tubal ligation or when tubal ligation was performed less than a year after delivery.
Desire for Tubal Reversal
In the 1995 National Survey of Family Growth, women who reported having a tubal ligation were asked the following question. "As things look to you now, if your tubal ligation could be reversed safely, would you want to have it reversed?" 24% expressed the desire for tubal reversal on the part of herself and/or her partner. 10% of the women said that they alone wanted tubal ligation reversal, 8% said that both they and their partners desired tubal reversal, and 6% said that their partner alone desired reversal of the tubal ligation.
Requests for information about tubal ligation reversal
In the CREST study, women younger than 30 at the time of sterilization were twice as likely to seek information as women ages 30 to 34. Women who had experienced changes in marital status were 3 times more likely to seek information than those whose marital status had not changed.
Although 13-24% of women desire tubal reversal or regret their tubal ligation, only 0.2% of women in the CREST study underwent tubal reversal. Reasons for this discrepancy include lack of information about tubal reversal, cost of the procedure, or the absence of insurance coverage. In many cases women receive inaccurate information about tubal reversal - such as their only treatment option is in vitro fertilization (IVF), or tubal ligation cannot be reversed, or tubal sterilization reversal is a high cost in-hospital operation.
Removing obstacles to tubal ligation reversal
Chapel Hill Tubal Reversal Center is the single medical facility that is exclusively for tubal ligation reversal. Follow-up statistics show that tubal reversal by Dr. Gary Berger has higher pregnancy and birth rates and costs less than the alternative treatment of IVF. Two-thirds of Dr. Berger's patients become pregnant within one year after tubal reversal surgery. The procedure takes an hour or less and there is no hospital stay. Dr. Berger's outpatient tubal ligation reversal procedure has been broadcast on the Discovery Channel and a free video or DVD is available that shows how it is performed. Patients and health care professionals consider Dr. Berger to be the best doctor for reversing tubal ligation.