IVFMD surgeons perform outpatient tubal reversal at a top notch DFW facility!
For women who regret having their tubes tied, the tubal reversal procedure can offer an good alternative to IVF, which for some patients can provide an average cumulative pregnancy rate of up to 80% a year after surgery.
How is the surgery performed?
We perform tubal reversal using microsurgical instruments via a 1.5-2 inch incision at the pubic hairline (bikini incision). The tubes are first identified and freed of any adhesions from the previous tubal ligation. The blocked ends are then resected and reattached to each other under the microscope to ensure the tubes are correctly aligned and perfectly sealed. A blue dye is then injected into the uterus and the end of the tubes are observed for spillage of dye.
The surgery usually lasts 1-3 hours and patients can go home on the same day after a short stay in the recovery area.
How much does tubal reversal cost?
We have negotiated with the hospital an affordable package for outpatient tubal reversal. A global fee of $6,500.00 will cover:
• Initial consultation with surgeon
• Preoperative, surgical and postoperative care at Baylor Surgical Hospital of Las Colinas
• Anesthesia fee
• Surgeon fee for 2 board-certified specialists experienced in microsurgical techniques
• Postoperative visit
Surgery is performed at Baylor Surgical Hospital of Las Colinas which offers the best in safety, state of the art equipment, and nursing/anesthesia support.
How successful is tubal reversal?
The success of the procedure is dependent on the age of the woman, the type of tubal ligation (clip, ring, cutting, tying, burning, part of the tube removed), the amount of tube remaining, and the health of the fimbria. The 12-month cumulative pregnancy rates by age and method of tubal occlusion are as followed:
|Age||Clip/Ring (%)||Resection (%)||Burning (%)|
Since the successful outcome of tubal reversal is dependent on the condition of the remaining tubes and the presence of any scarring due to previous pelvic infection or surgery, a laparoscopy may sometime have to be performed to assess tubal length and the overall pelvic anatomy before proceeding with the reversal.
In most cases, both tubes can be reconnected; however, in some situations only one tube may be healthy enough to be fixed, and rarely, neither tube can be repaired even with the best surgical effort. If only one tube is patent after surgery, it may take you a longer time to achieve pregnancy.
What are the risks of tubal reversal surgery?
The most prevalent risk of tubal reversal is an increased incidence for ectopic pregnancy (pregnancy outside of the uterus), which is 10% vs 2% for the general population. To reduce the risk of an undetected ectopic pregnancy, a urine pregnancy test should be performed after a missed period, and if positive, the pregnancy should be followed with serial serum HCG levels until the location of the pregnancy is confirmed by ultrasound. If a tubal pregnancy is detected early, it can be successfully treated with methotrexate without the need for surgery. Listed below are the main risks associated with tubal reversal:
- Ectopic pregnancy (10%)
- Surgical risks such as bleeding, infection, and injury to adjacent organs
- Anesthesia complications
- Inability to perform or complete the surgery (due to inadequate tubal length, severe pelvic adhesions, etc)
- Inability to attain pregnancy after surgery
What are the steps?
- Initial Consultation- During the consultation, which can be conducted via telephone, we will review your medical and surgical history and go over the medical records if they are available. Questions regarding the operation can also be answered to your satisfaction.
- A semen analysis is required before surgery because in case of severe male factor (very low sperm concentration or low motility) IVF is the only option. Your egg reserve will also be checked to make sure that you can still conceive using your own eggs.
- Preoperative evaluation– This is when you will meet us in person and undergo a physical exam. Our nurses will also review with you the preoperative and postoperative instructions.
- Two weeks before surgery please avoid NSAIDs such as aspirin and ibuprofen (Tylenol is fine).
- The day prior to surgery, please consume only light meals (preferably a liquid diet such as soup) and nothing by mouth after midnight.
Surgery and Recovery:
- The operation usually lasts 1-3 hrs under general anesthesia. The size of the Bikini incision is about 4 cm or (1.5-2 inches).
- Afterward, you will stay in the recovery area for several hours before being discharged during the afternoon.
- Most patients will do well with oral medications for pain and nausea. The prescriptions are provided during the preoperative visit.
- Most patients will need about 1 week off from work and 2 weeks without driving.
- You will return to clinic a week after surgery for postoperative check.
- In most cases, pregnancy can be pursued 4 weeks after the procedure and most patients will conceive within 6-8 months.
- Once pregnant, you will need close monitoring with HCG levels until an intrauterine pregnancy is confirmed by sonogram. If no pregnancy occurs after 6-12 months of trying, a hysterosalpingogram (HSG) may need to be performed to evaluate the patency of the tubes.
Tubal reversal or IVF?
- In cases of severe male factor, IVF is the better option.
- In case of pelvic adhesions from multiple abdominal surgeries (2 or more prior C-sections, myomectomy) or previous history of pelvic infection (PID, hydrosalpinx) or ectopic pregnancy, IVF is a better choice.
- Essure causes occlusion of the tubal portion that lies deep within the uterine wall, thus making it inaccessible for surgical repair without cutting into the uterine wall. Thus, for patients who had placement of Essure, IVF is a much better option.
- In 2007, a large European retrospective study showed that women at age 37 or younger attained a higher cumulative pregnancy rate with tubal reversal than with IVF. In contrast, women at age 38 or older had better chance to conceive with IVF.
Financing Options are available: