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Risks of
Tubal Reversal Surgery

Tubal reversal surgery can be more affordable and more successful than in-vitro fertilization. Tubal reversal surgery performed at A Personal Choice is an extremely safe outpatient surgical procedure. In our experience tubal reversal is one of the safest major gynecologic procedures with the lowest complication rates.

We keep a close eye on our operative complications. When you come to our practice you can be assured you will be getting the best care possible from a team dedicated to providing safe surgery. Our team is focused on our patients’ surgical safety and pregnancy success.

Our complication rates demonstrate surgery at our facility is safe and the risk of any major complication is low.

Tubal reversal complications

  • Blood Transfusion 0%
  • Major surgical site infections <0.5%
  • Minor surgical site infections <2%
  • Early operative/Anesthesia complications <0.5%
  • Unanticipated MD visit after surgery <2%

All patients are evaluated during scheduling for health conditions, which can increase the risk of surgery. Experienced anesthesia providers and nurses who are dedicated to the care of tubal surgery patients care for patients and all surgeries are performed by Dr. Monteith who has over 15 years of surgical experience in a variety of health care settings.

Tubal ligation reversal
Main risk

No surgical procedure or medical treatment is without risk. The main risk of tubal ligation reversal surgery is not surgery, but rather the increased risk of ectopic (tubal) pregnancy. An ectopic pregnancy is any pregnancy, which attempts to implant and grow at any location outside of the uterus. The most common location of an ectopic pregnancy is within the fallopian tube.

Any woman can have an ectopic pregnancy. The risk of ectopic pregnancy in the general population is less than 3%. The risk of ectopic pregnancy is increased after any condition that disturbs the normal function of the fallopian tube. Even when the fallopian tubes are perfectly repaired and open after reversal surgery the risk of ectopic pregnancy is increased.

The chance of ectopic pregnancy after tubal reversal is approximately 10%. If an ectopic pregnancy is not detected early then tubal rupture can occur if the pregnancy is allowed to grow within the tube without treatment.

More information Tubal reversal risks: An easy explanation

Our recommendations after reversal surgery

We propose a several step management plan to monitor our patients for the increased risk of ectopic pregnancy.

  1. We advise our patients to have close follow-up with their local physicians after reversal surgery and before pregnancy occurs.
  2. We will help facilitate our patient’s appointment with their local physician by sending a letter with our recommendations and a copy of the operative report soon after surgery. We will also provide patients with the same information.
  3. We ask patients to report pregnancies to our office as soon as they are detected.
  4. We encourage patients to see their local doctor soon after they detect pregnancy in order to begin early pregnancy monitoring.
  5. We recommend an early vaginal ultrasound as soon as the early pregnancy monitoring suggests a pregnancy should be visualized.
  6. If early monitoring diagnoses an ectopic pregnancy then we recommend medical treatment with Methotrexate medication, which can minimize the risk associated with ectopic pregnancy.

Early pregnancy monitoring
Decreasing risk of ectopic pregnancy

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 2000. 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 2000, 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 2000, 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 treated. 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.

Reason 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 end the tubal pregnancy 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 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

144 thoughts on “Risks of Tubal Reversal Surgery”

  1. Kelly Cowden says:

    How would i get my medical records of my tubal ligation to yall?

    1. Dr. Monteith says:

      Kelly
      The best place to obtain your records is from the Medical Records department where your procedure was performed.

      To send us your tubal ligation records for a free review use our ‘Fax Cover sheet’ and follow the instructions here: Contact Us: Sending Records For Review

      You can fax us your records to the number found on our Contact Us page or you can email us records to ContactUs@tubal-reversal.net

  2. Anonymous says:

    I am 45 years old and had my tube tied when I was 24 years old in Belize. I would like to untie my tube now to have a baby for my loving husband.

    1. Dr. Monteith says:

      We should be able to help you. It is harder to become pregnant with increasing age so I would not delay your decision for too long.

      We do have many patients who become pregnant with tubal reversal after age 40. Most of the women who become pregnant after reversal are between the age of 40 and 43.

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

      Please be aware that starting April 1st 2019 the fee for reversal surgery will increase to $6,900 and the scheduling fee will increase to $150. If you want to avoid the higher fees then you should schedule your surgery before April 1st or start a Reversal Prepayment Account.

      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.

      The alternative treatment is in-vitro fertilization (IVF). Most IVF doctors will recommend you use donor eggs after the age of 42. A single cycle of IVF averages $14,000 and average success is 38% for each try. After age 40 IVF success decreases quickly.

      For more information: Tubal reversal and age

      If you would like to get started then the best first step is to send us your tubal ligation records for a free review. Your tubal ligation records can be obtained from the Medical Records Department in the hospital where your tubal ligation was performed. Occasionally your doctors office may have the records. Sometimes patients may not be able to obtain their tubal ligation records. We can still proceed with surgery without records because we can reverse most tubal ligation procedures.

      To see more the success stories of older moms visit: Successful tubal reversal after age 40

      Here is a testimonial you may be interested in: “We Had Given Up” Tubal Reversal Mom Age 47

      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

      Call us at (919) 977-5050 8am to 5pm eastern standard time and we would be happy to speak with you about tubal reversal at our facility.

  3. Anonymous says:

    What if you are unable to obtain the surgery report from your tubal ligation? Are you still able to proceed with the consulation? It was done 2/2004.

    1. Dr. Monteith says:

      We can reverse most tubal ligations….even if you have no records!

      Many patients will come to us without records because they know we can repair most tubal ligation procedures…well over 90% of the time.

      You should try to get your tubal ligation operative and pathology reports by going to the medical records department in the hospital where your tubal ligation was performed.

      You should be able to request a copy of your tubal ligation operative report and a copy of the pathology report (a pathology report is only created when a segment of the tube is removed (typical with tubal ligations that involve tying and cutting the tubes). We can review these records free of charge.

      You can personally request your record from the hospital where your tubal ligation was done using our Medical Records Release/Request form: Medical Records Release Form

      You dont have to have your records to have tubal reversal at our center. You should consider our optional screening laparoscopy if you cannot get your tubal ligation records. Many patients come to us for reversal without records because they know we can repair most tubal ligations.

      We charge $6,400 for tubal reversal surgery. Many women may not be able to obtain their records…some will have surgery because they know we can repair most tubal ligations. Others will add on a screening laparoscopy.

      Please be aware that starting April 1st 2019 the fee for reversal surgery will increase to $6,900 and the scheduling fee will increase to $150. If you want to avoid the higher fees then you should schedule your surgery before April 1st or start a Reversal Prepayment Account.

      If you choose to have a screening laparoscopy we can look with a camera during the surgery and see if your tubes are repairable. If your tubes are not repairable or then we would offer you a refund of your surgical fee.

      For more information: Screening laparoscopy and surgery refund

      For more information: Screening laparoscopy and scar tissue

      Call us at (919) 977-5050 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

  4. victoria says:

    I have had my tubes tied for 19 months and I really am thinking I want a 4th baby. But it would also be a 4th csection.
    I had my 1st csection because my baby was breech so I decided to have my 2nd and 3rd csection as well. My doctor said I had 0 scar tissue and I didn’t bleed a lot. Also she said my uterus was thinning but that was it.
    I am 34.
    I didn’t know if I could have a spinal instead of general anesthesia for this surgery.
    It scares me to be completely under.

    1. Dr. Monteith says:

      Victoria
      We should be able to reverse your tubes. You should consider our screening laparoscopy because of your history of c-sections and the possibility of scar tissue.

      We charge $6,400 for tubal reversal surgery. You should send us your records from your tubal ligation for a free review. Sometimes patients cannot get their records. Even if you cannot obtain your records we would perform tubal reversal for you because we can reverse most tubal ligations most of the time.

      Tubal reversal can be 60% to 70% effective. The other treatment to become pregnant is In-vitro Fertilization (IVF) and this treatment cost averages $14,000 and is about 40% effective for each try.

      Tubal reversal is possible when you have a history of multiple c-sections. We have many patients who have successful reversal and pregnancy with a history of c-sections. The biggest concern with multiple (3 or more) c-sections is the possibility of severe scar tissue. If severe scar tissue exists then reversal may not be possible.

      We estimate that about 1 out of 12 women with 3 or more c-sections will have severe scar tissue that can make tubal reversal more challenging and in some cases not possible. For these patients we offer a screening laparoscopy. You can consider this similar to a surgery insurance policy. The laparoscopy costs an additional $1,500.

      If you choose to have a screening laparoscopy we can look with a camera during the surgery and see if you have severe scar tissue. If you have severe scar tissue we can often make a different incision…so this can increase the success of your procedure. If your tubes are not repairable or the scar tissue is too severe then we would offer you a refund of your surgical fee.

      For more information: Screening laparoscopy and surgery refund

      For more information: Screening laparoscopy and scar tissue

      Call us at (919) 977-5050 8am to 5pm eastern standard time and we would be happy to speak with you about reversal at our center.

      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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