Tubal Reversal
Sterilization reversal is the most successful fertility surgery done. When you decided that you wanted to limit your childbearing, your physician emphasized the ability of the procedure to render you permanently sterile. However, surgeons with special training in microsurgery are able to rejoin the separated segments of the tubes in a process known as tubal anastomosis or tubal reanastomosis.
The Procedure
The procedure is done using sutures finer than human hair. This requires the use of a microscope to enable the surgeon to assess the quality of the tube and simply to see the sutures and needles. The surgery requires attention to detail and takes from 2 to 3 hours to complete. Some surgeons state that the procedure will take only 1 hour to perform. Dr. Jutras uses a proven method in order to give his patients the highest potential for success post-operatively. He takes the time necessary to complete the procedure in the proper manner. No corners are cut in order to shorten the length of the procedure.
Recuperation time is variable with most office workers back to full activities in 2 to 3 weeks. Some more strenuous jobs may require up to 5 weeks off from work. Though we put some restrictions on work, there is no need to delay attempting conception. You can have intercourse one week after surgery. The average time to pregnancy is approximately 8 months.
Success Rates
The chance for pregnancy is determined by the method of tubal ligation. This is because the final length of the rejoined tube determines the chance for pregnancy and the speed with which pregnancy occurs. Women who have had tubal banding or clips ("Hulka" clips) have the highest pregnancy rate with delivery rates of 70 to 80%. Women who had a tubal ligation at the time of their last delivery or who had cautery (had tubes burned) have lower pregnancy rates of approximately 65%. This is because more tube is destroyed with these methods of sterilization.
In the last few years, we have begun to accept women over 40 for sterilization reversal. Success appears to be about half of the rate for women under 40 with take home baby rates of about 35% for women 40 to 43. There is not enough information to determine pregnancy rates in women older than this. We have seen pregnancy after surgery up to age 46. For women 43 to 45, tubal anastomosis is substantially better than the alternative procedure of In Vitro Fertilization (IVF).
Costs
Our cost for tubal anastomosis cannot be beat by any other surgeon in the U.S. Dr. Jutras was one of the first surgeons in the country to perform outpatient tubal reversals. His vast surgical experience makes him a true expert in the field. All cases are done in a free-standing ambulatory surgery center where the costs are less than one third of the cost in a hospital. The total cost of $5900 includes surgeon, anesthesia, and facility fees. An ultrasound is done before surgery to look for other fertility problems. This is also included in the fee. Warning: if you get other estimates, get it in writing!!
Alternatives to Surgery
For women who would rather not have surgery and are under 43 years of age, In Vitro Fertilization (IVF) offers an excellent alternative.
Feel free to contact our office with any questions that you may have.
