Tubal Reversal

About one million women in the United States undergo elective tubal ligation procedures each year. Many later regret the decision with thousands requesting assistance to reverse the procedure. Both reproductive endocrinologists at the Fertility Center can perform tubal reversals.

Evaluation of tubal damage may require that a woman’s uterus be evaluated through a hysterosalpingogram procedure and even a laparoscopy to determine the feasibility of surgical correction before a reversal can even be attempted. Reversal success rates are influenced by several factors including a woman’s reproductive age, the location and type of tubal ligation, how long ago the procedure was done, and the final tubal length after reversal. The best candidates for tubal reversal are women under age 31 who have had fallope ring or clip tubal ligations involving the portion of the tubes closest to the uterus and who have no known infertility factors. Less than five percent of women with tubal ligations have damage that cannot be repaired.  

With steady improvements in the pregnancy rates resulting from assisted reproduction, patients now have a non-surgical option through in vitro fertilization (IVF), which achieves conception without the fallopian tubes by fertilizing eggs outside the body and then transferring embryos to the womb for implantation. In nearly all tubal ligation cases, IVF offers the best chances for pregnancy success and exceeds the benefits of reconstructive tubal procedures. Note the risk factors, benefits and success rates compared below: 

Tubal Reversal Risks                                            IVF Risks
-  surgical complications                                       -  pregnancy with multiples (twins or triplets)
-  ectopic pregnancy                                               -  gonadotropin injection therapy
-  weeks of recuperation                                        -  ovarian hyperstimulation on rare occasions
-  need for contraception after delivery

Tubal Reversal Benefits                                        IVF Benefits
+  preferred if planning for many children           +  fastest route to conception
+  limited chance of multiples                               +  limited surgical and ectopic pregnancy risks
+  no injections                                                         +  a few days of recuperation
                                                                                     +  no need for contraception after delivery

Tubal Reversal Success Rates                            IVF Success Rates
■  40 to 50 percent                                                    ■  50 to 75* percent
     for patients age 35 or younger                               for patients age 35 or younger
     with pregnancy often taking                                    per IVF attempt
     up to 18 months to achieve                                    *rates increase when frozen embryos are used

Women face the dilemma of knowing the exact costs of both tubal reversal and IVF as well as whether or not insurance will cover these services. While many insurance plans do not cover reverse sterilization or infertility treatments, the majority will cover the diagnostic tests that can help determine which treatment is right for each patient. The doctors and staff at the Fertility Center understand the frustration of asking providers all the right questions about what type of benefits a plan includes, so benefits specialists call and verify coverage and exclusions before appointments. For women without infertility treatment coverage, the Fertility Center offers packages for IVF cycles ranging from $11,000 to $14,000, which include all treatment procedures, ultrasounds, labs, facility costs and anesthesia fees. Medication costs are additional.

Keep in mind that although the procedure for tubal reversal is a fixed cost, the fees for facility and anesthesia vary significantly, many times exceeding the cost of IVF.  Because of the variability in charges such as additional time needed for the procedure, complications and extended post-op observation, fees can range from $8,500 to $18,000, not counting the loss of income during the post-op period of four to six weeks.

Regardless of the procedure, financing is available. The Fertility Center guides each patient in choosing the option that best fits her budget, so call today for answers to questions or more information about insurance verification.