At A Personal Choice we specialize in fallopian tube surgery. We reverse permanent tubal ligation and we repair blockage of the fallopian tubes.
We are frequently asked by patients if tubal reversal causes pregnancy miscarriage.
In our previous article, Tubal Reversal and Miscarriage: Is There a Connection?, we explained what causes miscarriage and how common pregnancy miscarriage is in the general population.
There is a connection between tubal reversal and pregnancy miscarriage; however the reasons may not be exactly what you think.
Does Tubal Reversal Cause Miscarriage?
Many tubal reversal patients will ask if their miscarriage was caused by their tubal reversal or because of changes to their fallopian tubes after tubes were tied.
Some of our reversal patients may have multiple pregnancy miscarriages and it is only natural for them to ask if abnormal or shortened fallopian tubes can cause a higher chance of pregnancy miscarriage.
Tubal Reversal And Miscarriage
We maintain extensive statistics on the chances of pregnancy after tubal reversal.
This information was collected from our Tubal Reversal Success Study, which was conducted over a 10 year period from from July 2000 through December 2011. In this study we examined over 9,935 of our very own reversal patients and examined the success of their surgeries, pregnancies, and pregnancy outcomes.
The table below shows pregnancy outcomes based on the age of the patient at the time of tubal reversal surgery.
|<30||1128||614 (54%)||368 (33%)||146 (13%)|
|30-34||2823||1473 (52%)||931 (33%)||419 (15%)|
|35-39||2262||1079 (48%)||848 (38%)||335 (15%)|
|40+||443||169 (38%)||216 (49%)||58 (13%)|
In our study we observed that women less than the age of 30, their chance of miscarriage was around 34% and for women over the age of 40 the rate of miscarriage was about 60%. The risk of miscarriage increased with age of the patient.
The miscarriage rate after tubal reversal ranges from 33-49%. Obviously these are high numbers. The reported miscarriage rate for the average woman ranges between 10% to 20%.
It is important to understand these numbers are higher than the estimated average of 20% for the general population but there could be several other reasons for this observation.
Higher Rates Of Miscarriage After Reversal: Reason #1 Frequent Testing
The majority of women who have tubal reversal really want to be pregnant and, as a result, they generally perform more frequent pregnancy testing.
Most women have tubal reversal surgery to become pregnant.
When you want to become pregnant…you really try hard. Some patients want to be pregnant so badly they seem to be constantly doing home pregnancy tests!
They test before they miss their period, if their period is one or two days late, if their period is abnormal, and some even test after their periods.
Some will test if they have a headache, if they think they are nauseated, if they have mood changes, or if their boobs are sore!
This increased testing will pick up many early miscarriages that many women would not have otherwise suspected… or even known about. These early pregnancy losses are also called chemical pregnancies.
This is one main reason why it seems like women who have tubal reversal have more pregnancy miscarriages.
Higher Rates Of Miscarriage After Reversal: Reason #2 Older Moms
The risk of pregnancy miscarriage increase with increasing age of the woman.
Most women in the United States having children are between the ages of 20 to 30. Most tubal reversal patients trying to become pregnant are between the ages of 30 to 40. So, it stands to reason that tubal reversal patients (because they are older) will experience more pregnancy miscarriages than the general population.
More information: Pregnancy Miscarriage and Age
Most tubal reversal patients have previously had children. Most reversal patients consider reversal surgery five (5) to ten (10) years after their tubal ligation….and, obviously, this makes them all older. As a result, the pregnancy miscarriage rate will be slightly higher in the reversal patient population because of the increased age of this group compared to the general reproductive population.
Higher Rates Of Miscarriage After Reversal: Reason #3 Altered Tubal Anatomy
After reversal the fallopian tubes will always be SLIGHTLY different than they were before the tubal ligation procedure.
One of the main risks of tubal reversal surgery is ectopic pregnancy. An ectopic…or tubal pregnancy…is a pregnancy that is located outside of the uterus. The chance of ectopic pregnancy after tubal reversal is approximately 10%.
Many of these ectopic pregnancies will resolve on their own. So it is very possible many reversal patients are late for their period and will have a positive pregnancy test but the pregnancy is actually in the fallopian tube. These ectopic pregnancies may stop growing and resolve without any need for treatment. Many of these women will never know they had an ectopic pregnancy but will, more commonly, believe they had a pregnancy miscarriage.
Higher Rates Of Miscarriage After Reversal: Reason #4 More Willing To Tell
Most women in the general population are reluctant to openly share with family and friends that they had a pregnancy miscarriage. It has been our experience that many reversal patients join social media groups and are more willing to share and discuss with others that they have experienced pregnancy miscarriage.
Since this topic is so openly discussed it may seem that the chance of miscarriage is much higher than it really is…. or may seem higher than another group of friends. You have to realize that your other group of friends may experience miscarriage but not be so open about discussing this emotionally devastating events.
IVF And Miscarriage
Most people don’t think pregnancy miscarriage is possible with IVF…but it is.
An IVF cycle starts with the patient receiving hormonal medication to produce a large number of eggs. The eggs are then retrieved and then fertilized outside the body. Only the fertilized eggs that grow will be placed into the uterus. If an egg does fertilize, does not grow or stops growing, or does not attach to the uterine lining then this is an IVF pregnancy miscarriage.
According to the CDC, approximately 62% of all IVF cycles do not result in pregnancy when eggs were fertilized and placed into the uterus. Essentially this means 62% of all attempts to fertilize eggs and get them to grow did not work and did not result in a pregnancy.
So in essence approximately 62% of these IVF starts resulted in pregnancy miscarriage.
Chance Of Miscarriage After Reversal
Our final article in this series will discuss the chance of miscarriage after tubal reversal when looking at the lengths of the fallopian tubes after tubal reversal: Fallopian Tube Anatomy: Is Tubal Length Important?
Submitted by Dr. Charles Monteith