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Tubal Reversal Pregnancy Study
A Decade of Observations

Outcomes After Tubal Reversal
Births, Miscarriages, & Ectopic Pregnancies By Age

Table 7 shows the relationship between the age of reversal patients and outcome of tubal reversal pregnancies after tubal ligation reversal at our facility. With increasing age, the percentage of pregnancies resulting in births declined due to an increasing percentage of miscarriages. Among women under age 35, over half of pregnancies resulted in birth or ongoing pregnancy, while one third miscarried and 13% were ectopic (suspected or documented). The birth percentage was lowest and the miscarriage percentage highest for women 40 and older.

Whether there is an increased risk of miscarriage associated with tubal reversal is unclear. The miscarriage rate reported in the general population ranges from approximately 20% to 50% depending on a woman’s age and how early pregnancy testing is performed.

Ectopic pregnancies were more frequent than in the general population of women who have not had a tubal ligation, which is approximately 3%. Ectopic pregnancy after tubal reversal surgery may be overestimated, since some early pregnancy losses were reported as ectopic pregnancies when serum HCG levels did not rise normally and the pregnancies were interrupted with Methotrexate treatment. In these cases, it is not known whether the pregnancy was in the uterus (“blighted ovum”) or outside the uterus (ectopic). These are sometimes referred to as pregnancies of unknown location.

Table 7. Pregnancy Outcomes by Age

Age Pregnant Birth/Ongoing Miscarriage Ectopic
<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%)

Pregnancy Outcomes By Tubal Ligation Method

Table 8 shows the relationship between the tubal ligation method and pregnancy outcomes. Tubal ligation reversal after tubal clips (Hulka clip, Filshie clip) has the best outcome of all tubal ligation methods, with the highest percentage of births (70%) and lowest percentage of miscarriages (25%) and ectopic pregnancies (6%). Reversal of tubal rings (Falope ring, Yoon ring) has the second best outcome, followed in order by ligation/resection and coagulation.

These findings are almost certainly due to the minimal damage to the fallopian tube caused by tubal (Hulka or Filshie) clips.

Table 8. Pregnancy Outcomes by Tubal Ligation Method

Method Pregnant Birth/Ongoing Miscarriage Ectopic
Clip 660 459 (70%) 164 (25%) 37 (6%)
Ring 1070 601 (56%) 357 (33%) 112 (11%)
Ligation/resection 2616 1254 (48%) 949 (36%) 413 (16%)
Coagulation 1872 805 (43%) 733 (39%) 334 (18%)

Pregnancy Outcomes By Fallopian Tube Lengths

Longer fallopian tube segments are associated with better pregnancy outcomes than shorter tubes (Table 9). Among women with average fallopian tube lengths measuring 7.5 cm or longer, 65% of cases gave birth or had an ongoing pregnancy by the end of the study period. The percentage of births decline as miscarriages and ectopic pregnancies become more common with shorter tubal lengths. As discussed previously, the tubal lengths that remain after tubal ligation indicate the amount of damage caused by the sterilization procedure. The greater the amount of normal fallopian tube remaining, the better the chance of it functioning normally after tubal reparative surgery.

Table 9. Pregnancy Outcomes by Tubal Lengths (cm)

Length (cm) 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%)

The complete Tubal Reversal Pregnancy Study: A Decade of Observation can be viewed by using the following links:

Table of Contents

21 thoughts on “Tubal Reversal Pregnancy Report 2011 – Pregnancy Outcomes”

  1. Joanna says:

    Hi I had my tubes burned 10 years ago and i am 40 years old now what is the possibility of getting pregnant naturally. thank you

    1. Dr. Monteith says:

      Your chance of pregnancy over the next 10 years is the same as your chance the last 10 years. Tubal reversal is your best option to become pregnant. I would not delay your decision for too long because it is harder to become pregnant after the age of 42.

      We charge $6400 total plus $125 to schedule and we are located in Raleigh, North Carolina.

      Insurance will almost never pay for tubal reversal surgery. Patients pay in full and out-of-pocket at the time of scheduling. All you have to pay for in addition to the surgical fee is the cost of travel, hotel, and food.

      We do have a prepayment tubal reversal plan that allows you to save towards your reversal over a 3 year period.

      Although $6,400 seems expensive…the alternative treatment in-vitro fertilization (IVF) average $12,000 to $14,000 and is about 40% successful!

      The main advantage to tubal reversal is that every month you have a chance and you can become pregnant more than once.

      Call us at (919) 968-4656 8am to 5pm eastern standard time and we would be happy to speak with you.

      The following link will answer most of your questions about reversal. This is the MOST HELPFUL INFORMATION to read when considering reversal at our office. Each question has a link to more information about the question: Frequently asked questions about tubal reversal

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