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Tubal Reversal Pregnancy Report 2011

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

Meet Dr. Monteith

As a surgeon my reputation & integrity are extremely important to me. I’ve been providing new choices & new beginnings since 2008. I’ve had the distinct privilege of being the first surgeon in the world to report successful pregnancy within the peer reviewed medical literature after reversal of transcervical hysteroscopic tubal sterilization. Permanent is not forever at my practice! HAVE QUESTIONS?

What Our Patients Are Saying

“We had our surgery on 3/18/15 and on 02/02/16 our 7 pound 11 oz baby girl was born! I’m 34 years old and had tubal ligation done via clamps 8 years prior so this surgery really does work! 8 years later I had the reversal and 9 years later we were blessed with our little girl! So many doctors tried to talk us out of it-wanted us to do IVF to get our money-however praise God we went with this because it does WORK! Dr M is amazing and his staff! The area is beautiful where his office is, and if you do this procedure it will be the best money you ever spend!”

– Charlee-Belle M., Surgery

“From the very first phone call, the staff at A Personal Choice has been amazing! They have answered our numerous questions, concerns and have been amazing. They never give you false hope, but give you the complete story. I am so happy that we chose Dr. Monteith and his staff to make our dreams a reality. Can’t wait to start trying to have a baby. I would and have recommended Dr. Monteith to ANYONE wanting a tubal ligation or vasectomy reversal. Thank you all so much for giving us this chance!”

– Angela W., Essure Reversal

“Excellent service overall! Each stage of the process was carefully explained in great detail: how the procedure works, what to expect during the procedure, what to expect after, possible side effects. Dr. Monteith himself is very knowledgeable and experienced and quite personable too. He has a great sense of humor and uses it generously to put patients at ease. I highly recommend him and his staff to anyone considering either a vasectomy or a vasectomy reversal.”

Chris B., Vasectomy Reversal

“The perfect little angel that I’m holding in my arms right now is the best testament to what Dr. Monteith and his staff do for people. We could not be happier with our decision to use Dr. Monteith. His staff are just amazing. Our entire experience was just a dream! Thank you, from the bottom of our hearts, thank you!”

Jamie B., Reversal of Cut & Tied Tubes

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Ask The Doctor

Your questions about reversal surgery will be answered directly and promptly by Dr. Monteith. Please read our most frequently asked questions before submitting your questions. Dr. Monteith will not respond to general medical questions or if you are a patient of another doctor and are contacting him because your doctor is unavailable.* If you have been a patient at our reversal center and have specific questions about your medical care you should contact the reversal staff directly at (919) 977-5050.

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31 Comments

Lisa Reply

I’am a 43 year old woman as of Nov. I have had 4 natural live births. When tring to get pregnant with my now 13 year old son, we kept having miscarriages, even though we had never had any past issues. I also experienced 1 ectopic pregnancy. My ob/gyn sent me to Shady Grove Fertility in Baltimore, Md. (where im from) to find out what the problem was. My ob/gyn did a few tests and those results were sent to the specialist. When i finally seen the fertility specialist, he said there was no known cause for the repeated miscarriges and that I should continue to try to get pregnant until one “sticks”. So thats what we did. And i did finally have my son so he was right. I feel like everything is stacked against me. MY tubes were done with clips. Im 43. Had an history of miscarriges 14 years ago trying to have a 4th child for seemingly no reason and i had 1 ectopic pregnancy. The percentages on your site say my chances are only between 35-40%? Thats really low isnt it? I do still get very regular periods. But your site said your chances of pregnancy really start to go down at age 42, im just now 43 and it will take mee about a year to get the money together. With all honesty, is it even worth trying? Whats the Dr.s professional opinion of that? Also, could having that laproscopy give the Dr a better answer on what my chances are percentage wise? And finally, how much is that laproscopy?


    Dr. Monteith Reply

    Lisa
    Call us to speak with a nurse….but if you have tubal clips that is a great method for reversing. The chance of pregnancy could be as high as 80%. Age has a big role in your chances (whether you choose IVF or tubal reversal)…..so each year you wait your chances decrease. If you are having regular periods then you are releasing eggs and you have a chance to become pregnant. None of us can predict the future. Only you can decide if it is worth trying to get pregnant again….your choices are do nothing, adopt, spend a lot more on IVF (they will recommend donor eggs) or try tubal reversal that gives you the chance to become pregnant every month.