At 38 years old, is it better to have a tubal reversal or IVF?

I am a 38-year-old female who had her tubes tied 14 years ago. I would now like to have a child. Which would increase my chances of conceiving, a tubal reversal or IVF?

Answers from doctors (3)


Piedmont Reproductive Endocrinology Group

Published on Oct 15, 2015

At 38 years old, I would recommend moving straight to IVF for numerous reasons. By definition, a tubal ligation is designed to damage or “tie” the tube to prevent the oocyte from being able to travel down the tube for fertilization and subsequent pregnancy. Dependent upon the type of ligation performed, a reversal may not even be possible due to the irreversible damage. Unfortunately, the state of the tube is not known until the tubes can be examined internally. Sadly, in many cases, patients undergo the expense, pain of surgery, and extensive recovery just to be disappointed by the news that the condition of their tubes simply weren’t fixable. In many other cases, if the reversal can be done, the patient will have extensive scaring, making it very difficult for the sperm and egg to ever connect. This then prolongs the precious time and the number of monthly cycles it would take to conceive. Time is of the essence, especially if the patient desires multiple children.

Typically, when moving straight to IVF, a cycle can be planned, embryos transferred, and have an outcome within 60 days. Oocytes are collected directly from the ovary, so having a tubal ligation is of no consequence. While an oocyte retrieval is a “surgery,” it is much less invasive with NO incisions, minimal discomfort, and very little downtime. At age 38, patients electing to move straight for IVF can benefit from pregnancy rates as high as 50%. As a huge bonus, cryopreservation of remaining embryos for further family expansion use can alleviate the pressure of the maternal ticking clock. The embryos are genetically frozen at 38 years of age, regardless if they are not implanted until 48.

One last point to mention when considering tubal reversal verses IVF; some insurances will NOT pay for the reversal, but may offer some sort of infertility coverage. I would recommend definitely checking specific insurance plans prior to either procedure. For all these reasons, I would certainly recommend IVF over a reversal to any patients on the fence between the two procedures.

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Answered by Piedmont Reproductive Endocrinology Group

At 38 years old, I would recommend moving straight to IVF for numerous reasons. By definition, a tubal ligation is designed to damage or “tie” the tube to prevent the oocyte from being able to travel down the tube for fertilization and subsequent pregnancy. Dependent upon the type of ligation performed, a reversal may not even be possible due to the irreversible damage. Unfortunately, the state of the tube is not known until the tubes can be examined internally. Sadly, in many cases, patients undergo the expense, pain of surgery, and extensive recovery just to be disappointed by the news that the condition of their tubes simply weren’t fixable. In many other cases, if the reversal can be done, the patient will have extensive scaring, making it very difficult for the sperm and egg to ever connect. This then prolongs the precious time and the number of monthly cycles it would take to conceive. Time is of the essence, especially if the patient desires multiple children.

Typically, when moving straight to IVF, a cycle can be planned, embryos transferred, and have an outcome within 60 days. Oocytes are collected directly from the ovary, so having a tubal ligation is of no consequence. While an oocyte retrieval is a “surgery,” it is much less invasive with NO incisions, minimal discomfort, and very little downtime. At age 38, patients electing to move straight for IVF can benefit from pregnancy rates as high as 50%. As a huge bonus, cryopreservation of remaining embryos for further family expansion use can alleviate the pressure of the maternal ticking clock. The embryos are genetically frozen at 38 years of age, regardless if they are not implanted until 48.

One last point to mention when considering tubal reversal verses IVF; some insurances will NOT pay for the reversal, but may offer some sort of infertility coverage. I would recommend definitely checking specific insurance plans prior to either procedure. For all these reasons, I would certainly recommend IVF over a reversal to any patients on the fence between the two procedures.

Published on Jul 11, 2012


South Florida Institute For Reproductive Medicine - Pembroke Pines

Published on Oct 15, 2015

IVF is clearly a better option. At age 38, your egg quality is starting decrease. You can preserve your fertility with IVF.

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Answered by South Florida Institute For Reproductive Medicine - Pembroke Pines

IVF is clearly a better option. At age 38, your egg quality is starting decrease. You can preserve your fertility with IVF.

Published on Jul 11, 2012


Tubal reversal can be a better treatment to become pregnant than IVF. With IVF your chances are higher the month you have IVF treatment, but with tubal reversal you have more chances over time.

Answered by A Personal Choice Tubal Reversal (View Profile)

Tubal reversal can be a better treatment to become pregnant than IVF. With IVF your chances are higher the month you have IVF treatment, but with tubal reversal you have more chances over time.

Published on Jul 11, 2012


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