I’m a 33 year-old woman with 3 children. I’ve been sterilized and would like to become pregnant again. What are my chances and how can I help myself to become pregnant?
It is sometimes possible to reverse a tubal sterilization operation.
Early in the process you might want to check with your insurance folks.
The operations vary so much in price. They cost lots.
Any chance you could discuss this with the clinician who did the procedure?
Desire for Pregnancy Following Tubal Sterilization
Sterilization should be considered permanent, but even with careful counseling; some women will have a change in personal circumstance In vitro fertilization or microsurgical tubal reversal can be considered to attempt pregnancy following trans-abdominal sterilization. Success is not guaranteed with either approach.
The Essure device is, by design, placed in the uterine cornua, and therefore patients are not candidates for traditional microsurgical reversal. In addition, a 6 to 10 mm portion of the coil remains protruding into the uterine cavity after the device is placed, which could be detrimental both to the success of the in vitro fertilization (IVF) procedure and to the pregnancy, if achieved. FORTUNATELY, YOUR PROCEDURE WAS NOT AN ESSURE PROCEDURE. Pregnancy outcome data on IVF with the Essure device in place is not currently available. At this time, Essure should be considered an irreversible method of female sterilization.[i][i][i]
The choice between IVF and tubal surgery to achieve pregnancy following tubal sterilization is dependent on multiple factors, including the age of the woman at the time of treatment, severity of the tubal damage and remaining tubal length, as well as other fertility factors. With careful case selection and meticulous surgical technique, reasonable pregnancy rates can be achieved following microsurgical reversal of tubal sterilization.[ii][ii][ii]
Surgery, especially major abdominal surgery, carries operative risks as well as risks due to anesthesia. Ectopic pregnancy is more common among pregnancies occurring after surgical reversal of female sterilization. Ectopic pregnancy rates range from 1 % to 7%—higher rates can be observed in specific anatomical situations. Nonetheless, sterilization reversal may be appealing for younger women, couples who desire more than a single additional pregnancy, or those who are not comfortable with IVF. Both IVF and reversal surgery are costly and are often not covered by health insurance. Finally, those couples utilizing tubal reversal surgery may have the need for future contraception. A large Canadian study showed that 23% of women obtaining tubal reversal following sterilization went on to obtain a subsequent sterilization.[iii][iii][iii]
i][i][i] Ledger W. Implications of an irreversible procedure. Letter to the editor: Fert Steril 004.08.005
[ii][ii][ii] Lee D, Patton P. Tubal surgery and treatment of infertility. GO 04 Vol 5/ Chap 106 Reproductive Endocrinology, Infertility, Genetics.
[iii][iii][iii] Trussell J, Guilbert E, Hedley A. Sterilization failure, sterilization reversal, and pregnancy after sterilization reversal in Quebec. ObstetGynecol 2003;101:677-84.
According to Engenderhealth: A review of many studies reveals the chance of successful pregnancy to be roughly 50%. In actual practice they point out that this percentage is probably much lower.
Certainly I hope you will be advised by a clinician with extensive experience doing tubal reanastomosis operations. I am sure that you and your partner are considering whether you have any inclination to consider adoption. What are your partner’s thoughts about adoption? Are you ovulating fairly regularly?
Does all the above information help or is it just too much information (TMI)?
To learn more about the advantages and disadvantages of sterilization, go to our website: www.managingcontraception.com and click on Choices. You can also order this wonderful new educational book from our website or by calling 404-875-5001. Do you have your copy yet?