PREGNANCY RATES AFTER ESSURE REVERSAL AT A PERSONAL CHOICE
More information: Essure reversal testimonials
From January 2009 to January 3rd 2017, Dr. Monteith performed 282 Essure reversal surgeries (patients who desired pregnancy). Of this 282 patients 89 of these patients reported becoming pregnant without IVF. The chance of pregnancy after Essure reversal was approximately 32%.
In January of 2018, Dr. Monteith reanalyzed the same cohort of 282 Essure reversal surgery patients and 19 additional patients reported natural pregnancy. These were 19 new patients who became pregnant. These did additional patients did not include women who reported a second Essure reversal pregnancy. The total number of patients who reported pregnancy was 108.
- Overall chance of pregnancy after Essure reversal was 38% among all Essure reversal patients over the 9 year observation period.
Could Chances of Pregnancy After Essure Reversal Be Higher?
It is possible the chance of pregnancy is higher than 38%?
Monteith Miracle Essure reversal baby at 3 months of age
Patient Age. Age of the woman is always an important factor in determining the chance of pregnancy after reversal. Many patients were included who were 42 years of age or older at the time of reversal. It is harder to become naturally pregnant with increasing age of the mother. Including older patients can artificially lower the observed chance of pregnancy. The chances of pregnancy after Essure reversal may be higher than 38% for women under the age of 40.
Self Reporting. Pregnancy statistics are based on patient self-reporting pregnancy. Some patients don’t report pregnancy for privacy reasons. The chances of pregnancy after Essure reversal may be higher than 38%.
Previous Scientific Data. Tubouterine implantation has been the historical gold standard for surgical reversal of proximal tubal occlusion (blockage where the Essure device is located). Previous studies performed in the 1950’s and 1960’s on tubouterine implantation have suggested the chance of pregnancy could be as high as 50% to 60%.
Essure Reversal Statistics: Other Important Information
- Age range of women who successfully became pregnant after Essure reversal: 25 to 44
- Number of births reported by patients: 1 to 3 births (one woman had 3 births after reversal)
- Twins: Three patients reported natural twin pregnancies (3% of total pregnancies reported)
- Ectopic pregnancies reported 5 (5% of total pregnancies reported)
- Uterine ruptures reported 4 (4% of total pregnancies reported)
Ectopic Pregnancy After Essure Reversal
Essure Reversal Baby from Dr Monteith
The main risk of any tubal ligation reversal surgery is the risk of ectopic (tubal) pregnancy.
When reversing tubal ligation, the risk of ectopic pregnancy ranges from 10% to 15%.
Dr. Monteith has observed the risk of ectopic pregnancy after Essure reversal seems to be lower than when reversing other types of tubal ligation.
Based on patient self-reporting, the risk of ectopic pregnancy after Essure reversal is approximately 5%.
Dr. Monteith has hypothesized the risk of ectopic is lower in Essure reversal patients because Essure reversal either works or does not work… the fallopian tubes will either heal open or closed at the site of implantation.
- If Essure reversal works (one or both tubes heal open), the fertilized egg will make it into the uterus and will either be a normal pregnancy or a pregnancy that will miscarry.
- If Essure reversal does not work (both tubes heal closed) pregnancy will not happen.
More information: Why does tubal reversal increase the risk of ectopic pregnancy?
Reversal of other tubal ligation procedures result in the tubes being repaired in the middle of the tube. The area where the repaired fallopian tubes are rejoined will always an abnormal area where the fertilized egg may implant and develop in the tube.
Uterine Rupture After Essure Reversal
Essure causes blockage in the very beginning of the fallopian tube (the proximal portion of the fallopian tube).
The historical gold standard for surgically repairing fallopian tubes blocked in the location where the tubes insert into the uterus (proximal tubal blockage) is tubouterine implantation. This surgical procedure was first successful performed in the early 1900’s and more commonly in the mid-1900’s. There is a fair amount of medical literature highlighting the risk of uterine rupture after tubouterine implantation.
Of the 108 pregnancies reported to Dr. Monteith after surgically reversing Essure, four (4) patients reported uterine rupture.
More information: Essure reversal: Risk of uterine rupture
Uterine rupture can occur in any woman who becomes pregnant after a surgical procedure involving the uterine muscle.
Having a prior cesarean delivery is the most common risk factor for uterine rupture, but other uterine surgical procedures can also increase the risk of uterine rupture (ie fibroid tumor removal). Women who have four or more vaginal births also have an increased risk of uterine rupture. Most uterine ruptures occur while in labor or in the late third trimester.
Essure Reversal: Is C-section Necessary?
Dr. Monteith’s professional recommendation is for his patients to have planned Cesarean delivery (c-section) before going into labor with all future pregnancies after Essure reversal.
Dr Monteith of A Personal Choice
Dr. Monteith does not routinely record mode of delivery (vaginal birth vs cesarean) in his reversal patients. As a result, he does not have statistics on how every Essure reversal patient delivered. Most of his Essure reversal patients followed his recommendations and had planned Cesarean delivery before going into labor.
Some patients had vaginal births (either planned or unexpected) without any complications.
Some Essure reversal doctor’s will advise their patients they can safely have a vaginal birth after reversing Essure. Unfortunately, these recommendations may be misleading.
Women considering Essure reversal with doctors who claim Cesarean is not required should question the surgical techniques used by these doctors for reversing Essure. Some doctors report having an alternative technique for reversing Essure; however, many of these alternative techniques have never been reported in detail, have never been peer reviewed, and the success rates of these alternative techniques have never been studied or published. In fact, many of these doctors have very few, if any, Essure reversal pregnancies.
Should a uterine rupture happen in (1) a patient who is unaware of this risk and
(2) if the Essure reversal doctor has not discussed this unique risk with the patient’s primary doctor, an unexpected uterine rupture could have a catastrophic outcome for both mom and baby.
Essure Reversal Pregnancy Statistics: Not So Bad!
Dr. Monteith Essure Reversal Baby
With the above Essure reversal pregnancy statistics women can be assured their best chances of natural pregnancy after Essure reversal are with Dr. Monteith of A Personal Choice.
To date, no other doctor has published data on successful Essure reversal, has performed as many Essure removal surgeries, or has as many Essure reversal babies as does Dr. Monteith.
As a result of Dr. Monteith’s experience, Essure reversal is safe, can restore natural fertility, and can provide results comparable to IVF in some women.
Dr. Monteith’s Medical Publications On Reversing Essure
1. Normal pregnancy after outpatient tubouterine implantation in patient with Adiana sterilization
Monteith, Charles W. MD; Berger, Gary S. MD, MPH, Fertil Steril: July 2011 – Volume 98 – Issue Part 1 – pages e45-e46
2. Successful Pregnancies After Removal of Intratubal Microinserts
Monteith, Charles W. MD; Berger, Gary S. MD, MPH, Obstetrics & Gynecology: February 2012 – Volume 119 – Issue Part 2 – p 470–472
3. Pregnancy Success After Hysteroscopic Sterilization Reversal
Monteith, Charles W. MD; Berger, Gary S. MD; Zerden, Matthew L. MD, MPH, Obstetrics & Gynecology: December 2014 – Volume 124 – Issue 6 – p 1183–1189