Tubal Reversal: How to Decide for Reversal or IVF

Dr. David E. Simckes OB-GYN (Obstetrician-Gynecologist) Saint Louis, MO

Dr. David E. Simckes MD is a top OB-GYN (Obstetrician-Gynecologist) in Saint Louis, MO. With a passion for the field and an unwavering commitment to their specialty, Dr. David E. Simckes MD is an expert in changing the lives of their patients for the better. Through their designated cause and expertise in the field, Dr.... more

If you know that you want a Tubal Reversal then you have an easy decision. Just find a program like ours that has over 20 years experience, has an excellent track record and success rates, and offers the micro-surgical techniques at a fair cost. Choose a program where you go home the same day or within 24 hours. Choose a program that insists on performing a hysterosalpingogram after 3 months to demonstrate that their work was successful and the tubes are open.

There aren't many programs like ours that want to prove that their surgery worked by performing the "dye test", but we think it is only fair. Why go home and try for a year when the tubes are still blocked? You would be wasting valuable time. So maybe you should come to Saint Peters, Missouri. In the Show Me State we will show you our work was successful, or else ... we guarantee our work.

If you are not sure whether you should have a Tubal Reversal or IVF, then please continue reading.

If you are one of the many women or couples who are trying to decide whether or not to have a tubal ligation reversal surgery or move forward with in vitro fertilization, we try to make it easier for you here at Fertility Partnership. Most large studies have shown that usually it is better, at any age, to choose the tubal reversal surgery. At Fertility Partnership, we offer both services and can help you solve your dilemma. There is an old saying, “if you are a hammer then everything is a nail”. If you are clinic that only offers one of those services, tubal reversal or IVF, then that is what you’re going to recommend. We offer both and therefore we are able to make you a promise and a guarantee. If we perform the reversal and are unable to demonstrate that at least one tube is open three months after the surgery, then we will credit our surgeon’s fee to your IVF costs.

There are situations where we would not recommend tubal reversal as the first choice.

If the Ovarian Reserve, that is the egg reserve, is low. The Ovarian Reserve is determined by ultrasound and a blood test called Anti Mullerian Hormone, or FSH.
If the semen analysis demonstrates a significantly low sperm count that suggests that pregnancy is unlikely to be successfully achieved with just intercourse.
If the type of tubal ligation or any other circumstances suggest that there may not be enough tube to put back together again.

Before moving forward with the surgery we would like to meet with you, review your surgical records, check your egg reserve, and draw some blood tests. Unless we find a reason that the surgery is unlikely to succeed (for surgery and anatomic reasons), you can expect us to recommend tubal reversal as first-line. If the sperm count is very low then we will recommend in vitro fertilization. If your egg reserve is very low then we will probably recommend in vitro fertilization as first-line, but in the end, we will do what you say as long as there is potential benefit.

At Fertility Partnership, whenever we perform a tubal ligation we strongly recommend that couples refrain from trying to get pregnant for at least three months to allow the tubes to heal. Patients who do not heed this warning are at much higher risk for having a tubal pregnancy. Most programs perform the surgery and send you on your way and tell you to wait at least a year or more before declaring the surgery failure. No attempt other than to just "wait and see" is offered. At our clinic, after three months, we perform a hysterosalpingogram, the "dye test", to confirm that we have the tubes open. Approximately 90% of the time we will have at least one tube open and nearly 80% of the time both will be open. Our Doctor uses Microscopic Surgical Technique while performing these cases to give the highest success rates. If we have not managed to reverse at least one side then we will subtract our surgeon’s fee (approximately $2000) from the cost of performing in vitro fertilization at the Fertility Partnership. Unfortunately, we cannot apply the fees paid to the surgical facility which is approximately $4000.

There other factors to consider before deciding between tubal reversal and in vitro fertilization. For example, having your tubes reopened will give you an opportunity for a second or third child if you choose. On the other hand, with a good ovarian reserve, at IVF it is very likely that you will have extra embryos to freeze and could also have an opportunity for more children. Issues such as these will be discussed when you come in for consultation. A free telephone consult is also possible.