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Fallopian Tube Anatomy: Is Tubal Length Important?

Did you know that the chances of getting pregnant after tubal reversal are much higher when you have longer tubes after tubal reversal?

short-tubes-increase-chance-of-miscarriage-after-tubal-reversal-surgeryThe shorter the tubes after reversal… the chance of pregnancy miscarriage is higher.

The longer the tubes after reversal… the chance of pregnancy miscarriage is lower.

There are some really interesting facts about the chances of pregnancy miscarriage based on the length of the fallopian tubes after tubal reversal surgery.

In our previous articles. we explained what a pregnancy miscarriage really is in simple to understand terms.

Tubal Reversal And Miscarriage: Is There A Connection?

Is Miscarriage Higher After Tubal Reversal?

We also explained reasons pregnancy miscarriage may be higher in patients who have tubal reversal surgery.

This article will discuss our findings about pregnancy miscarriage after tubal reversal based on the length of the tubes after they have been rejoined during tubal reversal surgery.

Pregnancy Chances After Reversal: Fallopian Tube Length

We keep detailed statistics on many aspects of the reversal surgeries we perform. One detail that seems to be consistently relevant is the length of the fallopian tubes and the chances of pregnancy miscarriage after reversal surgery.

In our 2011 Tubal Reversal Pregnancy Study of over 9,108 of our own reversal surgeries, we observed the highest chances for successful pregnancy in women who have the longest fallopian tubes. Women with ‘shorter’ fallopian tubes had a lower chance for successful pregnancy when compared to women with longer fallopian tubes.

When the tubes were at their longest the chance of pregnancy was 83%. When the tubes were at their shortest the chance of pregnancy was 44%.

Pregnancy Rates by Tubal Length (cm)
Length Total Women Pregnant (No.) Pregnant (%)
7.5+ 824 684 83%
5.0-7.4 4949 3621 73%
2.5-4.9 3114 1932 62%
<2.5 221 97 44%

Chance Of Miscarriage After Reversal

We also examined pregnancy outcomes after tubal reversal and were able to make additional observations.

  • We observed women with the longest tubes had the lowest chance of miscarriage after tubal reversal.
  • Women with the shortest tubes had the highest chance of miscarriage after tubal reversal.

When the tubes were at their longest the chance of miscarriage was 27% and when the tubes were at their shortest the chance of miscarriage was 46%.

We have also observed natural and healthy pregnancies are possible with tubes of any lengths. 

So… just because you have short tubes after reversal surgery…don’t despair. You can still become successfully pregnant.

You always need to be hopeful. To help patients put it into better perspective, we often tell our patients:

  • Before tubal ligation reversal your chances of pregnancy were zero.
  • After tubal ligation reversal your chance of pregnancy, no matter what your tubal lengths, are much higher than zero!

This is a very simple way to explain that reversal allows them a much better chance to become pregnant again rather than doing nothing at all.

Pregnancy Outcomes by Tubal Length (cm)
Length Pregnant Birth/Ongoing Miscarriage Ectopic
7.5+ 684 447 (65%) 187 (27%) 50 (7%)
5.0-7.4 3621 1964 (54%) 1216 (34%) 441 (12%)
2.5-4.9 1932 771 (40%) 787 (41%) 374 (19%)
<2.5 97 24 (25%) 45 (46%) 28 (29%)

Does Tubal Reversal Increase Chance Of Miscarriage?

Does tubal reversal increase the chance of miscarriage? This answer to this question is uncertain.

The leading thought behind why miscarriage could be increased among women who have tubal reversal is the tubes are shorter than they normally would be because of the tubal ligation.

Most fallopian tubes are about 8 to 10 cm long BEFORE the tubal ligation.

Almost tubal ligations result in the removal of some portion of each fallopian tube. Only Essure and Adiana tubal occlusion tubal methods do not require removal of  any portion of the tube.

A woman’s tubes will always be shorter after reversal surgery than they were before the tubal ligation.

The only reversal patients who have close to normal length tubes after reversal are women who have tubal clips as their method of tubal ligation. Tubal ring patients usually have the second longest tubes…the rings do remove a small portion of the tube but not as much as most tying and cutting and burning procedures.

Some people mistakenly believe that shorter tubes are better because the fertilized egg will get to the uterus faster…. or cross the finish line sooner. Unfortunately, this may not be true.

Since the tubes are shorter the fertilized egg may get to the uterine cavity much quicker than it should and  may not be ready to attach itself.

Eggs usually get fertilized in the end of the tube near the ovary. Once fertilization happens the eggs starts to grow and divide as they travel down the tube. These fertilized eggs are getting ready for implantation.

short-fallopian-tubes-may-allow-fertilized-egg-to-get-to-uterus-too soonIf the tube is SHORTER then the egg may GET TO THE UTERUS FASTER and not be ready to implant.

Think of this situation. Once the egg is fertilized…a timer begins just like when you put a cake into the oven to bake.

The instructions may say bake in oven for 1 hour. If you only bake the cake for 40 minutes then your cake will not be fully cooked and you won’t be able to eat it…your cake will be a total loss!

Sometimes when eggs get to the uterus too soon they may not be ready to implant (attach) into the uterine lining.

Tubal Reversals And Miscarriages: Reasons

Although it is tempting to blame pregnancy miscarriage on tubal reversals and shorter length tubes, readers should realize miscarriage is common…a pregnancy miscarriage will happen in 1 out of 5 pregnancies of women who have never had a tubal reversal.

Miscarriages are very common in the general population and if frequent pregnancy testing was  done by the general population then the number of detected early miscarriages could even be higher than the estimated 1 out of 5 pregnancies.

Chemical Pregnancies

Women who have tubal reversal actively seek and desire pregnancy. As a result, they perform pregnancy testing more often and much earlier than most other women. When frequent pregnancy test are done, women will discover more early pregnancies that otherwise may not have been noticed and only resulted in a delayed period.

These pregnancies are often referred to as chemical pregnancies or very early miscarriages.

Older Age

As you become older your chances of miscarriage begin to increase.

tubal-reversal-patients-may-have-more-chemical-pregnanciesWomen who have tubal reversals are generally older than when they had children when they were younger. This statement is so obvious that it seems to almost make no sense!

Women who have reversal surgery are usually at a different stage of their life then when they had children earlier in their lives…..they are also at a different stage of their lives and older than when compared to the average age of other childbearing women in the general population.

According to the Centers for Disease Control, the average age of child bearing women in the United States in 2006 was 25 years of age. The average age of tubal reversal patients is around 34.

Miscarriage rates increase with age.

More Honest And Open Reporting

Women who have tubal reversal and are desiring pregnancy tend to be very open about pregnancy experiences. They may be more likely to openly share, discuss, and report pregnancy miscarriage whereas other women may not feel as comfortable doing so. This is very common during the age of social media.

Pregnancy support groups exist to support those trying to become pregnant. It can be very common to talk about bad pregnancy outcomes in a supportive environment. If you are just joining one of these groups…and all you see is one post after another about having a miscarriage…it is very easy to become biased and believe that miscarriages rates are more common because of what these women are going through.

Are your more likely to share that you had a miscarriage with others in a social media support group….or with other women at a friend’s birthday party?

Pregnancy And Uncertain Location

Women with shorter tubal lengths may actually be having more pregnancies of uncertain location.

These are pregnancies outside of the uterus and tube which resolve before their location can be determined. This would also explain the observed trend of increasing miscarriages among women with shorter tube lengths.

The presented pregnancy data does demonstrate a higher number of ectopic pregnancies with shorter length tubes. Although ectopic pregnancies are serious  some of them can be very subtle and resolve on their own without medical intervention.

Miscarriages Facts: Live As Young As You Can

Miscarriages are common and they do occur frequently. Pregnancy miscarriages occur with in vitro fertilization (IVF), tubal reversal, and in women who have never had infertility problems.

Most of our tubal reversal patients will have pregnancy success. The only way to minimize the risk of miscarriage is to live healthy, take a vitamin every day, and live as young as you can.

Need More Information About Tubal Reversal?

A Personal Choice Tubal Reversal Center is in Raleigh, North Carolina and specializes in tubal ligation, Essure, and vasectomy reversal surgery.

Dr. Monteith specializes in helping couples have more beautiful children with reversal surgery and helping women treat abnormal symptoms after their tubes have been tied!

If you would like more information about reversal, including the cost and success rates, then enter your email address below and you will be emailed more information about reversal.

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Women who need more advice about reversal are encouraged to join A Personal Choice’s public Facebook group:

Facebook Tubal Reversal Group of A Personal Choice

By joining the group you can communicate with other women who have had successfully reversed their tubal ligation and restored their natural fertility.

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