Tubal ligation reversal is very successful at allowing women who have had their tubes tied to become pregnant again. In general, 70% of women who have their tubes untied at A Personal Choice become pregnant after reversal of tubal ligation. This overall statistic is based on all patients, but there is variation depending upon an individual’s age and method of tubal ligation.
Tubal Reversal and Pregnancy Success
The success of a tubal reversal procedure depends primarily upon two factors:
· Method of tubal blockage
· Age of the patient undergoing reversal procedure
Tubal Ligation Method
The majority of tubal ligation procedures are done by tying and cutting a small portion of the tube (ligation and resection) or by laparoscopic (camera) coagulation (burning). These procedures are very common in the United States. The cutting and removal procedures are usually done after having a baby, either during a c-section or after a vaginal birth. The laparoscopic procedures are usually done at some time after pregnancy. Despite what people – including medical professionals – think and tell others, the majority of these tubal ligations can be reversed.
Patient Age At Time of Reversal
As a woman ages, her ability to become pregnant gradually begins to decline. All women, regardless of age, have to take this into account when evaluating pregnancy options. Women over the age of 40, who are considering a tubal reversal procedure, have to factor in the increased pressure of time into their equation of pregnancy success.
Age and Fertility
The graph below illustrates the impact of age on the probability of getting pregnant (black line) and the converse likelihood of experiencing infertility (green line).
As a woman ages, her likelihood of pregnancy gradually decreases and the likelihood of infertility increases. After the age of 44, approximately 5% of women will become pregnant naturally. This graph is a good visual description of the impact of age upon a woman’s fertility. Women over the age of 40 should consider the above information when deciding tubal ligation reversal, IVF, or adoption as alternatives for pregnancy.
Our tubal reversal patients have had excellent success in becoming pregnant after reversal. We have statistics in our 2007 pregnancy report showing the number of our patients based on age successful at becoming pregnant and also comparing tubal reversal to IVF regarding pregnancy and birth rates.
Comments about Age and Pregnancy
The medical community has termed pregnancy in women over the age of 35 as ‘advanced maternal age’. The choice of age 35 was somewhat arbitrarily set by medical professionals to describe increased problems with pregnancy as women become older. The two main problems which increase with age are increased chances of a genetic abnormality and/or risks of a medical complication during pregnancy or delivery. Many women hear the term ‘advanced maternal age’ and feel the medical community is saying they are too old to become pregnant. Sadly, the term has evolved to have a negative connotation when discussing pregnancy in women of this age group.
I practiced high risk obstetrics for eleven years and the vast majority of women over the age of 35 have perfectly healthy and normal pregnancies. In my opinion, the problems associated with advanced maternal age started to noticeably appear after the age of 40- but even then, most of these women did great! Most of the problems I saw during my career were among younger women with severe medical problems.
Although it is true that at some point pregnancy is not biologically possible, biological limits are different for each person. There is no single medical test which can tell this us when someone is ‘too old’. We can never determine if someone will or will not get pregnant and, as a result, we do not impose arbitrary age limits for women to have a tubal surgery at A Personal Choice.
The next article, Tubal Reversal After Age 40 – Adoption, will discuss the alternative of adoption. Following the adoption discussion, three articles will provide an overview of tubal ligation reversal: benefits, risks, and how to schedule. After discussing tubal reversal, we will then discuss IVF and IVF pregnancy results in older women.
Submitted by Dr. Charles Monteith
