Tubal reversal, also known as microsurgical tubal reanastomosis, is a procedure performed on women who have previously had their tubes "tied" in a surgical sterilization procedure.
We can help you decide if reversal is right for you based on your medical records. If you do not qualify for this procedure due to complete absence of tubes or low sperm count or other factors you may still inquire about In Vitro Fertilization (IVF) at our Center.
Our Center has vast experience in the performance of reproductive surgery including tubal reversal. Dr. Vermesh has been performing IVF and other infertility treatment procedures for more than 20 years. The success rate depends on a variety of factors including a woman's age, condition of her fallopian tubes, sperm quality and others. In almost every case, one or both tubes are successfully reconnected as evidenced by a dye test during the operation. If pregnancy does not occur within 6 months, an X-Ray study (HSG) will show if the tubes are still open. Conception rate following tubal reversal at our Center is approximately 70% within one year.
When patients change their mind about starting a family, the Center for Fertility and Gynecology can perform a tubal reversal.
The tubal reversal (AKA, tubal reanastamosis), is an outpatient surgery with low cost, quick recovery, minimal risk and a high success rate.
Microsurgical techniques, including use of specialized, highly precise instruments, eyelash sized sutures and surgical magnification glasses (loupes) allow us to repair blocked tubes with the greatest preservation of normal anatomy and tissue integrity. The procedure is initiated with a small (5-7 cm) "bikini" incision made 2 cm above the pubic bone and below the pubic hair line. After entering the abdomen, the uterus, ovaries and tubes are evaluated. It is at this time that we repair any prior scarring of the tubes and any disfiguration of the anatomy. We also use this time to confirm that each tube has a fimbria (the flower like open end that picks up the egg). Next, one tube is placed in the center of the surgical field and the blockage is isolated and excised (removed) using a combination of the scalpel, surgical scissors and electro-cautery where necessary. Once we have established that the separate tubal pieces are now patent (open), the tubes are re-connected using 3-6 stitches placed in a circumferential manner. Following this, we inject a blue dye through the uterus and up into the tubes. When the dye spills out the fimbriated end of the tube, we have confirmation that the reanastamosis was successful. The same process is then carried out on the other tube. Finally, we return the uterus to its natural position in the bottom of the pelvis, close up all the layers of the abdomen and suture the skin closed with absorbable stitches.
The entire procedure usually takes 1 and ½ to 3 hours depending on the anatomy and a person's build. Patient's are typically discharged from the outpatient surgery center within two to four hours and can expect to resume normal activities within one to two weeks (job dependent). This is different from the typical approach to tubal reversal, which requires a larger incision and a one to three day hospital stay with a four to six week recovery.
We are very proud of our refined technique and feel that our excellent success rate reflects our attention to detail and consistent approach. We have found that we are able to open and reconnect (reanastamosis) the tubes over 90 percent of the time.
We recommend that a copy of the operative report or your tubal ligation be obtained from your doctor or from the medical records department of the hospital where you had your procedure done. If you would like to forward this information to us, a doctor will review the operative report and you will be contacted thereafter. You may fax the records to our office at (818) 881-1857. Please include your present name and the name under which the tubal ligation was performed. Also include a telephone number so that we can contact you after reviewing your records. A consultation would then be your next step.
During your consultation the risks, benefits, side effects, potential complications, outcomes and alternatives are discussed in detail. It is important that all of these issues are understood before the procedure is performed. Out of town patients may have some of these issues covered by phone. An in person conversation ensures that the message has been received.
A semen analysis can be done prior to the surgery. Unexpected male fertility is a relatively common problem. An abnormal semen analysis may greatly affect the decision to have a tubal reversal as opposed to In Vitro Fertilization with ICSI. For women 35 and older, checking FSH level on day three of the cycle may rule out unexpected decline in fertility.
When pregnancy occurs, it is important to have a physician actively determine its location as soon as possible, because tubal pregnancies do occur at a higher than normal frequency in women who have had a tubal reversal.
Recovery And Post-Operative Period
You will awake from the procedure in the recovery room, where you will be observed for 2-3 hours. Upon discharge, you will receive a prescription for pain medication and instructions regarding diet and activity. In general we recommend return to normal diet within 1-2 days and return to normal activity within 7 days. Wound dressing may be removed after 2 days.
You can try to conceive one month after the procedure. If you are not pregnant after 6 months of trying, we will recommend an x-ray of your uterus and tubes (HSG). If your tubes are blocked you will need to proceed with In Vitro Fertilization (IVF). If your tubes are open, we will advise you on management options.
When you are pregnant, we recommend early monitoring. You should contact your local physician and/or our Center for instructions. We want to be kept informed about your pregnancy. Click here to contact us or call us at 818-881-9800.
The Center for Fertility and Gynecology will perform your microsurgical tubal reanastomosis (tubal reversal) for the price of $5900.00
This $5900.00 includes:
- Pre-operative examination including pre-operative blood work
- The CFG surgical fee (surgeon and assistant surgeon)
- Operating Room Fees + Anesthesia Fees
- Post-operative follow-up visit
- Consultation $275
- Patients with BMI (Body Mass Index) of 25 or above will be charged an additional fee.
- Calculate your BMI - http://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm
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