When You’re Pregnant after Your Tubal Reversal
After tubal reversal: follow-up care
Congratulations on your positive pregnancy test!
We know you have been waiting for this moment since the start of your tubal reversal journey and we share your excitement and concerns.
Now that you are pregnant, we would like for you to:
- Contact your doctor and begin the Early Pregnancy Monitoring protocol
- Notify us of your pregnancy with our Pregnancy Report Form
- Update us on your pregnancy with our Tubal Reversal Update Form
- Notify us of your babies birth with our Tubal Reversal Birth Report Form
- Update us about symptoms after reversal with our Tubal Ligation Symptom Update Form
Tubal Ligation Symptoms
If your tubal reversal surgery was to evaluate abnormal symptoms after tubal ligation then use the
Tubal Ligation Symptom Update Form to update us about your symptoms since having your tubal surgery.
Your personal experience and insight is helpful to other women.
Pregnancy report forms
Use the Pregnancy Report Form when you first realize you are pregnant. We want to be informed about every pregnancy and the information you provide is vital to our pregnancy statistics.
Not only do we want to be informed about every pregnancy, but we also want to be updated on the status of your pregnancy. Use the Tubal Reversal Update Form to let us know how your reversal pregnancy is progressing.
Use the Tubal Reversal Birth Report Form to let us know when your baby is born. Once we receive notice of your baby’s birth we will send you a ‘Monteith Miracle’ or ‘Berger Baby’ onesie t-shirt.
We take pride in our work and we enjoy seeing our tubal reversal babies grow up. Update us on your reversal baby at anytime by submitting a Tubal Reversal Update Form. Feel free to attach ultrasound, baby shower, newborn, and birthday pictures to share your experience with us. Your feedback validates the work we do and also provides hope for others who may be considering corrective tubal surgery.
Early pregnancy monitoring
The best way to determine the location of an early pregnancy is with blood testing for the pregnancy hormone (quantitative serum HCG). Using this testing the location and health of an early pregnancy can often be determined before a pregnancy is seen during an ultrasound exam.
We recommend monitoring your early pregnancy with quantitative serum HCG blood tests every 48 hours and having a vaginal ultrasound exam when your HCG (pregnancy hormone) level reaches 1500. This testing should be started soon after you first detect pregnancy and can be stopped as soon as the location of the pregnancy is determined.
When the pregnancy hormone level reaches 1500, a vaginal ultrasound exam will show a gestational sac (early pregnancy) within the uterus in a normally developing intrauterine pregnancy.
If your ultrasound exam does not reveal a pregnancy inside your uterus, you should have a repeat HCG level and have another vaginal ultrasound exam within 2 or 3 days. Sometimes the early pregnancy may not be seen until HCG level is about 2500 depending upon the quality of the equipment and experience of the person performing your ultrasound examination.
If the early pregnancy is not seen inside the uterus when the HCG level is above 1500-2500, then the pregnancy is abnormal and likely to be either a tubal pregnancy or a pregnancy that will eventually miscarry.
Because the risk of tubal pregnancy is approximately 10-15% after tubal surgery, it is important to notify your obstetrician-gynecologist and follow the Early Pregnancy Monitoring protocol to determine the location and health of the early pregnancy.
A tubal pregnancy cannot lead to a live birth and must be interrupted. Following the recommended Early Pregnancy Monitoring Protocol is the best way to minimize the risk of tubal rupture, preserve the health of your fallopian tubes, and avoid surgery to remove the tubal pregnancy.
Rationale for early pregnancy monitoring
The rationale for early pregnancy monitoring is to prevent a tubal pregnancy from progressing to the point of rupturing the fallopian tube. Rupture of the fallopian tube results in internal bleeding and requires emergency surgery, often resulting in loss of the fallopian tube. In the absence of ultrasound evidence of an intrauterine pregnancy, early treatment with Methotrexate is recommended to terminate the pregnancy. After Methotrexate administration, serum HCG levels should be monitored until the HCG level returns to less than 10 mIU/dL.
Early pregnancy monitoring: Key concepts
The key concepts to understanding HCG pregnancy hormone testing and ultrasound exams are:
- In a normal pregnancy the HCG levels should double every 48 hours
- In a normal pregnancy the pregnancy should clearly be seen inside the uterus when the HCG level is above 1500-2000
- If the HCG levels are not doubling or the pregnancy is not seen inside the uterus when the HCG levels are above 2000 then the pregnancy is abnormal, possibly in the fallopian tube, and will not lead to a live birth
Keep us informed
We want to be kept informed about your reversal pregnancy, the progress of your pregnancy, and the birth of your baby! We are available if you have questions or concerns.