Pregnancy After Tubal Reversal
When You Become Pregnant
Bonnie Ayscue, RN, BSN
One of our nurses will be in contact with you during the first few days after surgery. We will then contact you at regular intervals after surgery to see how you are doing. If you have questions at any point following surgery, you can contact us by phone or e-mail. Most questions can be addressed during regular business hours. However, you will receive an after hours number and your tubal reversal surgeon's pager number for any emergency calls that need to be addressed outside of normal hours.
It will be helpful to use an ovulation predictor kit following your surgery. You can purchase the kits over the counter at any drugstore or online at www.saveontests.com. There are instructions with the kit, but we will provide you with directions for use during your consultation. If you do not detect your LH surge while using the kit, please contact one of the nurses to let us know. We are happy to make recommendations on follow-up care with your local doctor. If any fertility medications will be used after reversal, these will need to be ordered by your local doctor so you can be closely monitored.
If you are not pregnant within 6 to 12 months following surgery, it is recommend that you have a HSG (hysterosalpingogram) x-ray to be certain that your tubes have remained open. Please have a copy of the x-ray films, as well as the report, sent to our office for review.
When You Become Pregnant:
Part of our long-term follow-up care after your tubal reversal is monitoring your pregnancy along with you and your local physician.
It is important to follow our recommendations for monitoring your early pregnancy. We recommend biweekly (twice a week) quantitative serum HCG and progesterone assays. A vaginal ultrasound examination should be performed when your HCG reaches 1500. At this point, a uterine pregnancy will usually show a gestation sac within the uterus. If your US exam does not show the gestation sac, your HCG level and another vaginal ultrasound exam should be repeated in 2 or 3 days.
In a normally developing pregnancy, the serum HCG levels will double every 2 or 3 days until about 10 weeks from the last menstrual period. If the gestation sac is still not seen in the uterus when the serum level of HCG is above 1500, then a tubal pregnancy or a "blighted ovum" (abnormally developing uterine pregnancy) should be suspected.
Because of the increased risk of ectopic pregnancy following tubal surgery, it is important to notify us as soon as your pregnancy test is positive. A tubal pregnancy cannot lead to live birth and must be interrupted. By following our pregnancy monitoring protocol, a tubal pregnancy can be detected early in its development when it can be treated with medication (Methotrexate). Once the pregnancy is reabsorbed and a normal period follows, patients can try to conceive again. If a tubal pregnancy is allowed to progress without early diagnosis, it will eventually damage the fallopian tube and require surgical treatment, possibly involving removing the tube entirely.
The main point about early pregnancy monitoring is to prevent a tubal pregnancy from progressing to the point of rupturing the fallopian tube. A ruptured fallopian tube causes internal bleeding and requires emergency surgery. Pain in one side of the lower abdomen or pelvis, abnormal spotting or bleeding, rising HCG and progesterone levels with failure to see a gestation sac in the uterus when the HCG levels are above 1500 are some of the warning signs of a tubal pregnancy with the risk of tubal rupture. Adhering to our recommendations for early pregnancy monitoring can prevent tubal rupture.
We want to be kept informed about your early pregnancy results. Your tubal reversal surgeon is available at any time by pager if you have questions or concerns. You can also reach our nurses seven days a week by e-mail or cell phone. Chapel Hill Tubal Reversal Center Cannot order HCG or ultrasound testing for patients. The patient's local doctor must order these tests.
On our website you will find a Pregnancy Report Form. Please complete the form and submit it when you have a positive pregnancy test. If you do not hear back from us within 24 hours, please e-mail or call us at (919) 968-4656 or page your tubal reversal surgeon. We want to be sure we know about your pregnancy so we can assist you during this important time for you and your family!
Watch Video - Why Tubal Reversal?
Patients often have asked Dr. Berger what made him decide to specialize as a tubal reversal doctor. In this short video, Dr. Berger talks about his thoughts regarding tubal reversal surgery to help families have children and why he limits his practice to this operative procedure. During his years as an infertility specialist, Dr. Berger found that tubal reversal surgery was the most successful of all of the treatments available. As proof of this, examine the latest statistics about pregnancy after tubal reversal surgery for our patients!