Patient’s History
Ana G. was one of the 4 patients I operated on today at A Personal Choice. 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 A Personal Choice 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 A Personal Choice.
