Pregnancy after tubal ligation? Worth talking about again

I think I get about 5 emails a week from people who had tubal ligation surgery and now would like to conceive. It is worth talking about again:

Tubal ligation Reversal surgery can be successful at opening up the fallopian tubes and allowing pregnancy, however, if the tubal ligation was done more than 10 years ago, or if the tubes were cut and burned then success rates are very limited. It was used in the past because in vitro fertilization (IVF) had such low success rates, so it was the best option. Now, however, IVF has much higher pregnancy rates than tubal reversal surgery, is also expensive and has some other benefits. Here are the pros and cons of each.

Tubal reversal:

Pros: 1. if the tubes are successfully put back together then you have an opportunity for pregnancy each month (typical chance of pregnancy per cycle is 15 to 20% depending on your age). 2.You do not have to use any fertility medication to conceive.

Cons: 1. you have a higher likelihood of having a tubal pregnancy (ectopic) due to the surgery, 2. The surgery can cost up to $16,000 and may require an additional overnight stay in the hospital. 3. Tubal ligation reversal is abdominal surgery and the recovery time can be up to 4 weeks. 4. Once you are through with child-bearing, you must use contraception to avoid pregnancy or have another tubal ligation.

In vitro fertilization (IVF):

Pros: 1. much less expensive than tubal reversal (about $9300 including estimation for medication costs), 2. less invasive than tubal ligation reversal (recovery time is one day), 3. pregnancy rates (depending on age) are about 50% per embryo transferred, 4. You will typically have more than one embryo produced from the cycle, giving you multiple chances for pregnancy,  5. once you are done with child bearing there is no need to use contraception.

Cons: 1. fertility injections must be used to produce the eggs, 2. the IVF cycle must be planned in advance.

 In either case,  successfully having a baby will depend on how healthy you are and your age. Women who are unhealthy are less likely to conceive. Women who are over 36 will have a lower chance of conception with either procedure as there is a natural decline in fertility rates after this age. Smokers and women who are not of normal height and weight (so either too thin or obese) have a decreased chance of pregnancy from the start. Additionally, these women also have an increase rate of miscarriage.