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Have a Tubal Ligation but Now Wish to Regain Fertility?
Our fertility experts will be happy to discuss your options with you including the possibility of undergoing tubal ligation reversal surgery. Affordable options are available. Call 866-600-Care now or click here to schedule a consultation.
Options For Future Fertility After Tubal Ligation:
- In vitro fertilization and embryo transfer (IVF). This technology enables you to conceive by bypassing the tubal blockage (see below for more information).
- Tubal ligation reversal (TL reversal). This is a surgical procedure which reverses the tubal ligation (see below for more information).
- Consider adoption: see below for more information.
Humberto (Bert) Scoccia, MD is Professor and Director of the Division of Reproductive Endocrinology and Infertility and he has 20 years' experience in performing tubal microreanastomosis (tubal reversal).
Several factors need to be taken into account when making the decision as to which option to follow:
- Age: (TL reversal <40yrs pregnancy rates 50-70%, after 40 yrs pregnancy rates 10-20% vs IVF <40 yrs pregnancy rates 30-45%, after 40 yrs pregnancy rates 5-15%)
- Approach: Surgery (TL reversal) vs No surgery (IVF, adoption)
- Cost Estimates: (TL reversal -$10,000; IVF- $10,000 + fertility medication, about $5,000; adoption $10,000-20,000)
- Male factor: Sperm count (Men with low sperm counts, below 20 million sperm per milliliter, or low sperm motility may require IVF in order to father a pregnancy and are not good candidates to have their partner undergo a TL reversal).
- Ovarian reserve testing: FSH levels <10 mIU/ml pregnancy rates 30-45% vs FSH levels >10 mIU/ml pregnancy rates 5-15%
- Payments: (TL reversal- $16,000; IVF -upfront payment of $10,000 + fertility medication costs of about $5,000; adoption $10,000-20,000)
- Success: (TL reversal- overall pregnancy rates 50-70% per year vs IVF pregnancy rates 30-45% per completed attempt)
- Type of Sterilization: There are several procedures performed for tubal sterilization which may affect TL reversal success rates (Falope ring 50-70%, Pomeroy post-partum tubal ligation 50-70%, tubal coagulation 50-70%, multiple site tubal coagulation 0%, removal of the fallopian tube 0%, Essure sterilization 0%)
Patients desiring to proceed with adoption need to consider several options.
- For a domestic adoption a couple needs to decide between an independent (non-agency) adoption and an agency adoption.
- For an international adoption a couple will be adopting a child from another country and will need to follow the laws of that country.
- Clearly a couple considering adoption will need proper legal advice in order to undertake this process.
- Counseling may also be considered by couples considering adoption.
- Estimated Costs for an agency or international adoption plus legal advice may range between $10,000-20,000.
Resolve is a national infertility association which can offer practical guidance to couples seeking to pursue adoption. For more information please visit resolve.org.
The American Society for Reproductive Medicine (asrm.org) also provides patient information and has a fact sheet on adoption which may be helpful to couples considering this process (asrm.org/Patients/Fact Sheets/Adoption-Fact.pdf)
In Vitro Fertilization
In Vitro Fertilization and Embryo Transfer (IVF) involves fertilization outside the body in a laboratory environment. To date, thousands of babies have been delivered worldwide as a result of IVF treatment. Over the years, the procedures to achieve IVF pregnancy have become increasingly simpler, safer, and more successful.
Procedures: To Accomplish Pregnancy as a Result of IVF,
Several Steps are Involved:
- Stimulation of the ovary to produce several fertilizable oocytes (eggs)
- Retrieval of the eggs from the ovary
- Fertilization of the eggs and culture of the resulting embryos in the IVF Laboratory
- Placement of the embryos into the uterus (womb) for implantation (embryo transfer)
Complications: Multiple pregnancies (40%), tubal pregnancy (3%), preterm labor, bleeding during pregnancy, cesarean section (60%) and overall increased risk during pregnancy which requires close follow up by your obstetrician.
Costs: Patients who are not covered by medical insurance should be aware that the UI Center for IVF & Fertility Program offers a complete IVF cycle, including ICSI and assisted hatching for under $10,000. Certain tests and procedures are excluded and medications (about $5,000) are not included in this package. Please contact Billing at 312.996.4322 for more information
Tubal Ligation Reversal
- Procedures: Tubal ligation reversal (TL reversal) surgery is performed through a small cut (about 2 inches) above the pubic hair line, or via laparoscopy. The separated ends of the fallopian tubes are then examined using magnifying lenses and any scar tissue is removed. At this point, the ends of the tubes are rejoined with extremely small resorbable sutures, the size of a fine hair. At the same time, a blue dye is injected through the cervix of the uterus (mouth of the womb) to confirm that the tubes are indeed open.
- Complications: The likelihood of actual complications during surgery is small but include infection (1%), injury to abdominal organs during surgery (<1%), failure of reversal after surgery (10-30%) and the possibility that the subsequent pregnancy may be an ectopic (tubal) pregnancy (10-15%).
- Costs: The procedures are performed at the University of Illinois Hospital. There are several charges associated with the surgery and bills are generated from the Hospital, the surgeon and the anesthesiologist. Patients who are not covered by medical insurance should be aware that the UI Center for IVF & Fertility Program offers an outpatient (same day) tubal reversal package for $16,000. Postoperative hospitalization or surgery complications are not included in this package. New or existing patients wishing to make an appointment to discuss TL reversal please call the University of Illinois Fertility Center at 312.355.2634.