Can I get a tubal reversal if I am 37 years old and have my operative report but not my pathology report?

I had a tubal ligation in 1999; I'm now 37 years old. I would like to get a tubal reversal. Though I have my operative report, I do not have the pathology report. Will this affect my ability to have the procedure?

ANSWERS FROM DOCTORS (7)


Answered by Sanford Health Fertility and Reproductive Medicine

Thank you for the email. There are many things to consider when deciding if a tubal reversal is the right choice for you and your family.

The obvious advantage with a tubal reversal is the hope that you will be able to achieve pregnancy with no interventions. The typical estimate is that, if everything goes well and all things are optimal, about 75 percent of women will achieve pregnancy within their 1st year of trying. If there are any factors that are not optimal, the chances for success can be significantly lower.

Here are some things to consider:

• Before a tubal reversal should take place, we first need to know if it is a good option. For example, we need to think about egg quality, your age, tubal status, endocrine status, and it is very important to know what the sperm quality is of the male partner. The consultation fee will vary depending on the facility and they may or may not include fees for lab testing on both partners.

• If you are determined to be a good candidate, surgery will need to take place. The success of the surgery can often not be determined until after the surgery. For example, what conditions are the tubes in and is there any scar tissue or endometriosis. The cost of surgery is typically between $18,000-$24,000. Again, this varies between facilities. There are cheaper rates posted on the Internet, but often they are not including the hospital fees. The surgery typically requires 6-8 weeks of leave from work due to the open incision.

• If the reversal is “successful," the chance of success is still not ensured. For example, there is an increased risk for ectopic pregnancy.

• After a reversal, you will also have to consider birth control options (e.g. contraception vs. tubes tied again)

The other option is obviously IVF. The benefits of IVF are:
• Cost typically is less than 12-15K on average
• Many variables can be worked around
• Success rate each month is much greater
• Options for prevention of genetic disease through new genetic screening
• Option to screen embryos for chromosome or genetic conditions to decrease the chance for having a baby with a syndrome, or a miscarriage, through a process called preimplantation genetic testing

There are obviously drawbacks as well:
• Requires medication for stimulation
• It is not the “natural” option that some couples desire

There is much to consider prior to deciding what is the best option. The first step is a consultation with a fertility specialist to discuss your history and start your lab work up. From there, you will be advised on the options that best fit your needs.




Published on Feb 19, 2015

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Answered by Sanford Health Fertility and Reproductive Medicine

Thank you for the email. There are many things to consider when deciding if a tubal reversal is the right choice for you and your family.

The obvious advantage with a tubal reversal is the hope that you will be able to achieve pregnancy with no interventions. The typical estimate is that, if everything goes well and all things are optimal, about 75 percent of women will achieve pregnancy within their 1st year of trying. If there are any factors that are not optimal, the chances for success can be significantly lower.

Here are some things to consider:

• Before a tubal reversal should take place, we first need to know if it is a good option. For example, we need to think about egg quality, your age, tubal status, endocrine status, and it is very important to know what the sperm quality is of the male partner. The consultation fee will vary depending on the facility and they may or may not include fees for lab testing on both partners.

• If you are determined to be a good candidate, surgery will need to take place. The success of the surgery can often not be determined until after the surgery. For example, what conditions are the tubes in and is there any scar tissue or endometriosis. The cost of surgery is typically between $18,000-$24,000. Again, this varies between facilities. There are cheaper rates posted on the Internet, but often they are not including the hospital fees. The surgery typically requires 6-8 weeks of leave from work due to the open incision.

• If the reversal is “successful," the chance of success is still not ensured. For example, there is an increased risk for ectopic pregnancy.

• After a reversal, you will also have to consider birth control options (e.g. contraception vs. tubes tied again)

The other option is obviously IVF. The benefits of IVF are:
• Cost typically is less than 12-15K on average
• Many variables can be worked around
• Success rate each month is much greater
• Options for prevention of genetic disease through new genetic screening
• Option to screen embryos for chromosome or genetic conditions to decrease the chance for having a baby with a syndrome, or a miscarriage, through a process called preimplantation genetic testing

There are obviously drawbacks as well:
• Requires medication for stimulation
• It is not the “natural” option that some couples desire

There is much to consider prior to deciding what is the best option. The first step is a consultation with a fertility specialist to discuss your history and start your lab work up. From there, you will be advised on the options that best fit your needs.




Published on Jul 11, 2012


Answered by The Fertility Center of the Carolinas

Before doing the surgery I would suggest you have someone check your ovarian reserve, essentially how many eggs you have left, as women are born with all the eggs they will ever have. The other issue here is the time since your tubal ligation. The longer the time frame from the initial surgery can affect success, as can the way they performed your tubal ligation. IVF will most likely be your highest chance of pregnancy given these circumstances.

Published on Feb 19, 2015

Answered by The Fertility Center of the Carolinas (View Profile)

Before doing the surgery I would suggest you have someone check your ovarian reserve, essentially how many eggs you have left, as women are born with all the eggs they will ever have. The other issue here is the time since your tubal ligation. The longer the time frame from the initial surgery can affect success, as can the way they performed your tubal ligation. IVF will most likely be your highest chance of pregnancy given these circumstances.

Published on Jul 11, 2012


Answered by South Florida Institute For Reproductive Medicine - Pembroke Pines

Not having a copy of your pathology report should not affect your ability to have a tubal reversal. On the other hand, having your operative report is very important because some types of tubal ligations are not good candidates for reversal. For example, when a tube is cauterized (or burned) as part of the tubal ligation, there may not be enough healthy tube left for your doctor to reconstruct a functional tube.

Published on Feb 18, 2015

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Answered by South Florida Institute For Reproductive Medicine - Pembroke Pines

Not having a copy of your pathology report should not affect your ability to have a tubal reversal. On the other hand, having your operative report is very important because some types of tubal ligations are not good candidates for reversal. For example, when a tube is cauterized (or burned) as part of the tubal ligation, there may not be enough healthy tube left for your doctor to reconstruct a functional tube.

Published on Jul 11, 2012


Answered by Fertility Insitute of Hawaii

This should not affect your ability for the reversal, but will be discussed more in length with your attending physician.

Published on Feb 18, 2015

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Answered by Fertility Insitute of Hawaii

This should not affect your ability for the reversal, but will be discussed more in length with your attending physician.

Published on Jul 11, 2012


Answered by Southern California Reproductive Center

The path report is helpful, but not necessary. You can take your operative report to a fertility specialist and he or she can use that along with an examination to determine your candidacy for a tubal reversal. Should a tubal reversal be performed and you do not become pregnant in the first year after the procedure, you may want to consider in vitro fertilization (IVF). This method is an option since you would be 38yo and possibly have a lower ovvarian reserve. Note: you should have an AMH blood test to test your reserve before a reversal.

Published on Feb 18, 2015

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/1926_1422480044.jpg
Answered by Southern California Reproductive Center

The path report is helpful, but not necessary. You can take your operative report to a fertility specialist and he or she can use that along with an examination to determine your candidacy for a tubal reversal. Should a tubal reversal be performed and you do not become pregnant in the first year after the procedure, you may want to consider in vitro fertilization (IVF). This method is an option since you would be 38yo and possibly have a lower ovvarian reserve. Note: you should have an AMH blood test to test your reserve before a reversal.

Published on Jul 11, 2012


Answered by Piedmont Reproductive Endocrinology Group

Yes, you can still potentially have the tubal reversal surgery performed. If, after reviewing the op note, there is any question about how much of the tube was involved with the original surgery, a laparoscopy can be done prior to making the incision to assess the tubes.

Published on Feb 18, 2015

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Answered by Piedmont Reproductive Endocrinology Group

Yes, you can still potentially have the tubal reversal surgery performed. If, after reviewing the op note, there is any question about how much of the tube was involved with the original surgery, a laparoscopy can be done prior to making the incision to assess the tubes.

Published on Jul 11, 2012


Answered by A Personal Choice Tubal Reversal

It is more ideal to have your pathology report but sometimes it is unavailable. That said, it should not prevent you from getting a tubal reversal if you have your operative report, have been examined and your fertility specialist, based on this information, deems you a candidate for the procedure.

Published on Feb 18, 2015

Answered by A Personal Choice Tubal Reversal (View Profile)

It is more ideal to have your pathology report but sometimes it is unavailable. That said, it should not prevent you from getting a tubal reversal if you have your operative report, have been examined and your fertility specialist, based on this information, deems you a candidate for the procedure.

Published on Jul 11, 2012


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