Tubal Ligation Reversal or In Vitro Fertilization?

If you have had a tubal ligation and have decided that your family is not complete, what are your options for conceiving a child again?

Tubal ligation reversal or In Vitro Fertilization (IVF) are your options.

Tubal ligation reversal can be a successful procedure to reopen the fallopian tubes and lead to fertility, however, it depends on how the initial tubal ligation procedure was performed and how long ago it was. If your tubes were cut or burned (or both) there is not typically enough tube to put back together. If it has been more than 10 years, there may be too much scar tissue.  Tubal ligation surgery is typically more expensive than IVF because it must be done in a surgical center and sometimes can lead to an overnight stay in the hospital. This surgery is not typically covered by insurance and the cost can be up to $15,000. The advantage of the surgery is that, if successful, each month you will typically have a normal chance of conception for your age group. One disadvantage is that you will have to use contraception once you have had the children you want and the incidence of tubal pregnancy (ectopic pregnancy) is higher in women who have had tubal surgery.

In Vitro Fertilization is often the best choice for patients. This is a process where we stimulate the ovaries to make eggs and then remove the eggs from the body, fertilizing them in the laboratory. We then put the embryos back into
the uterus to achieve a pregnancy. IVF is more cost effective (about $8800 including fertility medication) and is less invasive than the surgery for tubal ligation reversal. Another advantage of IVF is that you do not have to worry about
subsequent contraception. With IVF we have the advantage of controlling the number of embryos we return to the uterus and we can freeze additional embryos for use in the future. IVF after tubal ligation is not typically covered by insurance.

Before you pursue either option, you will want to know that you are in good health and that you are having normal ovulatory menstrual cycles. Additionally, you will want to be of appropriate height and weight, with a body mass index under 30.  Also, you will want to make sure that your husband or partner has a normal sperm count. Age is an important factor in your reproductive success. Women over the age of 40 will need to realize that their fertility is compromised due to age alone even though they did not have difficulty conceiving in the past.

Please call our office for specific information about your case and for a review of your operative report. We can help you make the choice that is right for you.