Chances Of Pregnancy After Essure Reversal
2018 Essure Reversal Pregnancy Statistics
Most health care professionals believe Essure can only be removed with a hysterectomy or complete removal of both fallopian tubes. Most health care professionals believe Essure reversal and natural pregnancy are not possible.
We are making believers out of many of the doubters. Essure reversal and natural pregnancy are both possible with Dr. Monteith.
An internal analysis of over 469 Essure removal surgeries performed by Dr. Charles Monteith demonstrates the chances of pregnancy after reversing Essure is comparable to the chance of pregnancy after a single cycle of in-vitro fertilization (IVF) and Essure reversal can allow for more than one pregnancy.
Dr. Monteith is the world’s leading Essure reversal specialist. After successfully reversing both Essure and Adiana sterilization, Dr. Monteith published the first surgical case reports (2011 and 2012) on successful pregnancy after reversal of hysteroscopic sterilization (Essure and Adiana).
In 2014, Dr. Monteith published a cohort study on the success of Essure reversal surgery. This was a landmark study because: (1) most doctors will tell you Essure cannot be reversed successfully (2) this study showed many patients became pregnant after Essure reversal….not just one or two ‘lucky’ pregnancies.
In 2017, Dr. Monteith performed and interval analysis and updated his Essure pregnancy statistics to include two years of additional Essure reversal statistics.
In 2018, Dr. Monteith updated his Essure reversal pregnancy statistics with more years of patient follow-up.
Most people (including infertility experts) believe Essure sterilization cannot be reversed.
The experience of Dr. Monteith and his Essure reversal patients would suggest many of these infertility experts are wrong: Essure is reversible and natural pregnancy is possible.
Essure reversal vs Essure removal: What is the difference?
Many people are confused by the terms “Essure removal” and “Essure reversal“.
• Essure removal is a surgical procedure for women who are having symptoms after Essure but do not want to become pregnant.
• Essure reversal is a surgical procedure to help women who want their Essure devices removed and also want to become pregnant naturally.
Some doctors remove Essure by manual traction (pulling on the devices).
Some doctors ‘reverse’ Essure by cutting the tube, applying manual traction to the Essure devices (pulling on the devices), and rejoining the cut tubal segments. Pulling on the devices increases the risk of device fragmentation and rejoining the damaged tube will, most likely, not result in pregnancy.
Simply removing the devices and rejoining the tubes will not provide the best chance of pregnancy.
When a skin piercing is removed and not replaced the hole in the skin will eventually heal closed. Dr. Monteith believes the same will happen if the tubal ends are rejoined after removing Essure devices with the manual traction technique.
Dr. Monteith’s Essure reversal technique involves removing the Essure devices intact with surrounding scar tissue by using an ‘en bloc dissection‘. This technique is important because it minimizes the chance of device device fracture during removal.
After the devices are removed, the remaining healthy fallopian tubes are re-inserted into the uterine cavity. This is called a tubouterine implantation procedure.
Dr. Monteith believes tubouterine implantation provides the best chances of pregnancy after the Essure devices are removed.
Essure Reversal Pregnancy Statistics 2018 Update
From January 2009 to January 3rd 2017, Dr. Monteith performed a 2017 Essure Pregnancy Analysis. He performed 282 Essure reversal surgeries to restore natural fertility.
In 2017, he observed the chance of pregnancy after Essure reversal was 32%.
In January of 2018, Dr. Monteith performed an updated 2018 Essure Pregnancy Analysis on the original cohort of 282 patients who had Essure reversal. This allowed an additional year for this group of patients, especially Essure reversal patients from 2017, to report pregnancy. The inclusion of this additional year was important because it allowed more time for women to report pregnancy and a more accurate assessment of the chance of pregnancy after Essure reversal.
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%?
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
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 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!
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