Tubal Ligation Reversal

Chapel Hill Tubal Reversal Center.

Saturday, April 28, 2007

Tubal Reversal Pregnancy Study Report 2007

Summary


Results of the most recent and largest study of pregnancies and pregnancy outcomes after tubal reversal surgery are now available from the Tubal Reversal Pregnancy Study Report 2007. This is a prospective observational study of over 3000 women who had their tubal reversal procedures performed by Dr. Gary Berger during the 5 year period 2001-2005. The overall pregnancy rate after tubal reversal was 69%. Age at the time of reversal surgery was an important factor associated with pregnancies and their outcomes. Age-specific pregnancy rates were: 82% for women under 30, 76% for ages 30-34, 67% for ages 35-39, and 41% for women 40 years or older. Pregnancy outcomes were also associated with age. Younger women had lower miscarriages rates and higher birth rates than older women.


This article provides highlights of the study - the complete report can be viewed here:



Introduction


Many people are unaware that tubal ligation - usually considered a permanent method of birth control - can be reversed through low cost, one hour outpatient surgery. Even many physicians believe that in vitro fertilization (IVF) is the only treatment option for women who want another baby after having a tubal ligation. Information is widely available about IVF pregnancy and birth rates in the United States from the Centers for Disease Control (CDC). Tubal reversal statistics, however, are more difficult to find, and in the past, they have been based on relatively small patient numbers. The recent report from the Tubal Reversal Pregnancy Study provides outcome data from a large patient population with follow-up from 1 to 5 years after surgery.


Study Methodology


There were 3,019 women who had tubal reversal procedures performed by Dr. Berger at Chapel Hill Tubal Reversal Center from January 1, 2001 through December 31, 2005. They were followed up at regular intervals to determine the outcomes of their procedures. The 2007 report includes data through December 31, 2006, giving a minimum length of follow-up of 1 year and a maximum of 5 years. Some of the women reported more than one pregnancy during the study interval. All pregnancies and their outcomes were recorded in an electronic database and included in the data analysis.


Patient Population


The women’s ages ranged from 23 to 50, the average being 34 years old. They came from a wide geographic distribution in the United States as well as from other countries. This map gives an overview of the resident locations of the US patients.


Figure 1. Resident Locations of US Patients

Map shows where Dr. Berger's patients come from throughout the United States for their tubal reversal procedure by the most experienced tubal reversal doctor.

The methods of tubal ligation among this group of women were ligation/resection (40%), coagulation (29%), ring/clip (22%) and fimbriectomy or unknown (9%).


Tubal Reversal Techniques


All tubal reversal operations were performed using outpatient mini-laparotomy surgical and anesthetic techniques that minimize tissue injury, blood loss, anesthesia time, postoperative pain, and recovery time. These techniques are shown and described by Dr. Berger in a video called Outpatient Tubal Reversal that has been broadcast on Discovery, The Learning Channel and the CBS Early Show. The tubal reversal procedures included microsurgical tubotubal anastomosis, ampullary salpingostomy, and tubouterine implantation.


Results


Pregnancy Rates by Age


As expected, younger women had higher pregnancy rates than older women. The overall pregnancy rate was 69% and age-specific pregnancy rates ranged from 82% for women under 30 to 41% for women 40 years of age and older.


Pregnancy Outcomes by Age


Age also was associated significantly with the outcome of pregnancy. As age increased, the percentage of pregnancies resulting in births declined. This was a result of more frequent miscarriages with increasing age. Among women under age 35, over half of pregnancies resulted in birth while one third miscarried. The birth rate declined to 40% as the miscarriage rate increased to 45% for women ages 40 and older. Independent of age, the ectopic pregnancy rate was significantly higher (16%) than that found in the general population, which is approximately 2.5%. Whether tubal reversal results in an increased risk of miscarriage is unclear, but it seems unlikely since the miscarriage rate reported in the general population ranges from approximately 20% to 40%, depending on a woman's age and the extent of early pregnancy testing.


Pregnancy Rates by Age and Tubal Ligation Method


Pregnancy rates taking into account both age and tubal ligation method are shown in Table 3. The highest pregnancy rate (87%) was reported by women age 29 or less who underwent reversal of a previous ring or clip method of sterilization. The lowest pregnancy rate (31%) was for women age 40 and older with either a fimbriectomy or unknown method of tubal ligation. Of the two variables, age is more predictive than tubal ligation method of the likelihood of becoming pregnant after reversal surgery.


Comment


Ongoing patient contact is necessary to provide pregnancy and outcome statistics after tubal reversal surgery. At Chapel Hill Tubal Reversal Center, nurses enter information into an electronic patient database at the patient's registration, the surgical procedure, and all post-operative communications between patients and staff. Patients are contacted routinely at 6 and 12 month intervals after their tubal reversal procedure if they have not been in regular contact with the Center's staff. The comprehensive follow-up database at Chapel Hill Tubal Reversal Center is unique. To our knowledge, no other doctor or medical facility maintains such a long term, ongoing follow-up system to determine the outcomes of tubal reversal procedures. This approach to long term follow-up and data collection may serve as a model for other physicians or clinics to document the results of tubal reversal procedures.


About The Author


Dr. Gary Berger is a member of the Board of Directors of INCIID. He is a reproductive surgeon who limits his practice to tubal reparative surgery. Dr. Berger is the Medical Director of Chapel Hill Tubal Reversal Center – the only facility that is exclusively for tubal reversal surgery.

Thursday, April 26, 2007

Choosing The Right Tubal Reversal Doctor

Tubal Reversal Message Board discussion about choosing the right doctor for tubal reversal surgery is summarized with this message: "Experience, cost, statistics, bed-side manner.... pick it... decide what criteria you want to use to judge the options on... Dr. Berger will come out on top EVERY TIME!".

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Posted by Thibgirl0028 (Member # 10944) on April 25, 2007 10:52 PM:

I have been researching seems like forever to find the right Dr and i keep coming back here but I am not to safe with that idea I just wish someone can tell me the choices of why Dr Berger he seems wonderful but so confused Helppppppppppppppppppppp. I just need some help on deciding I want to get it done as soon as possible but need the Right Dr

or please u can email me at thibgirl0028@aol.com thanx yall r life savers i am tired of researching I want to hear good and bad

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Posted by Hospicegurl (Member # 10548) on April 25, 2007 11:17 PM:

I hope someone can chime in on this and help you! I haven't done the TR yet. But everytime I looked up anything about it just keep coming back to him the nurses is really great that I do know they will answer any question for you as best as they can.

I think the pregnancy rate speaks for Dr.Berger all in its self.

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Posted by Dreamweaver (Member # 9903) on April 25, 2007 11:40 PM:

I have checked out both Dr.s and I could tell you what I didn't like about the other Dr but I'd rather tell you what I do like about Dr. Berger. He does 4 TR's a day 5 days a week. He has done nothing but TR's for years Has done over 5,000 TR's
He has published numerous medical journals and some books specifically related to TR's His office makes each of us feel special while at Chapel Hill.
Did you do a wikipedia search? It even has him listed in the definition They followup with us, especially through email or phone WHENEVER we have a question or concern. He has been known to fix other issues while performing the TR.
He has a high success rate of repairing most TR's and he lays it on the line with what you can expect once your in recovery for your TTC future.

I know it's confusing because you have the choices between two Dr.s Whichever Dr. you decide to go with, it's needs to be your choice. I made my choice and I am glad of the choice I made. PS I am a lurker on the other board, so I see alot of what happens between the Dr.s operations and honestly, Dr. B I believe was the better choice for ME.

I'm probably missing other important points about Dr. B but I'm sure others will chime in and let you know how they feel about Dr. B.
Good Luck with whichever Dr. you chose.
Karen

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Posted by LOVE & LUCK (Member # 9504) on April 26, 2007 12:27 AM:

Like the others said it speaks for itself, but if I have anything to chime in about it is the fact that I had my TR surgery on April 18th 2006 and had my son on April 2nd 2007. In less then a year I have a beautiful baby in my arms. I think that is the most valid example I can give. Good luck whatever you choose, but Dr. B is the best choice.

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Posted by TheMzD (Member # 6500) on April 26, 2007 01:31 AM:

Thibgirl0028 - I may have a bit of different perspective. I had my TR with Dr B 9/29/04 - it was a wonderful experience, He is amazingly patient, gentle and kind. His staff are truly amazing, and supportive.

I however have not been pregnant. Not a single positive pregnancy test in all this time. There have been months when I've cried when my period starts, and months when I've been angry that we've done everything "right" and still no luck. I do not regret going to Dr Berger though - he gave me the best chance possible to get pregnant. And that is what this surgery is - a chance - so follow your heart, go with the doctor you feel is right for you.

I went with Dr Berger simply because he has the most experience, his techniques have been improved on over YEARS of doing this surgery daily. If your tubes can be repaired, go with the doctor who can give you the best chance possible.

Best wishes as you make your decision,
Kay

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Posted by Nancy Medical Secretary (Member # 4179) on April 26, 2007 08:58 AM:

Thibgirl0028,
I hope these ladies are helping you with your decision. We appreciate all the good things that everyone has to say about Dr. Berger. Please remember that we strive for excellance in the care of each patient, but it is still in God's hands in the end.
If you would like you could get a copy of your operative report from your tubal ligation and fax it to us at 919-967-8637 and one of our tubal nurses will get back with you after reviewing this report with Dr. Berger and advise you on your journey.

Remember there is no charge for this review. Hope to see you soon and wishing the best to you on your decision.
Nancy


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Posted by bridgetmillsaps (Member # 10654) on April 26, 2007 09:06 AM:

As an extremely discriminating and picky client, I can tell you that my experience with Dr. Berger and his staff was absolutely perfect. Even though it's surgery, it's the type of experience that makes you almost miss Chapel Hill after you are gone!

The staff is so cheerful and good-natured...the office is very nice...everyone put me completely at ease before, during, and after surgery. We felt so comfortable with the nurse who came to the Sheraton post-op to check on me. I just can't say enough. And to top it off, I got PG the month after my TR (on Valentine's Day!) and am expecting in December.

They are a class act. I'm SO glad I didn't go anywhere else. I give them an A+++++++++++++++++ rating...and you'll hear a lot of those types of comments on here. It's just an amazing place.

Good luck with your decision and best of luck.
Bridget (age 39)
TR 2-14-07
BFP 3-25-07
EDD 12-06-07
My tubes were 4.5 and 5.5

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Posted by apicolet (Member # 10776) on April 26, 2007 09:14 AM:

Seven years ago I look up getting a TR and prayed about it. I didn't have money at that time. But still look up stuff about Br.Berger and kept coming back to him. I talk to other doctor and there cost was alot more and you had to spend spent time in hosp.

I look to see if I could find anything bad on Dr.Berger and there was nothing. I got my TR 3/3/07 and the staff was wonderful and still are.
Hope this Helps.

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Posted by Eric'sGirl (Member # 10652) on April 26, 2007 09:45 AM:

First - it is your decision... you need to do what you feel in your heart is right for YOU. That being said...

In my opinion, there is NO OTHER DOCTOR! Dr. Berger beats the "competition" HANDS DOWN no matter what facet of TR you explore... Dr. B and his staff treat every woman like she is the only woman in the world.

Before surgery... even if you never make it there... they still do everything they can to answer questions, get the right information in front of you so that you may make an informed decision.

I haven't had mine yet... but I have seen nothing but RAVE REVIEWS for the amazing day you spend with Dr. B and the staff. After surgery... haven't found anything else that compares to the support from Dr. B and his staff - and all the women he has brought together.

Experience, cost, statistics, bed-side manner.... pick it... decide what criteria you want to use to judge the options on... Dr. Berger will come out on top EVERY TIME!

Best of luck to you. We are all here for you... whether you choose Dr. Berger or not.

Chrissy

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Posted by pam mills (Member # 617) on April 26, 2007 11:33 AM:

My heavens, thanks to all of you for such words of praise. I must say that working for Dr Berger is our privilige. Through his leadership and example we have become quite efficient at what we do. My goal is to give each and every patient an experience that feels safe, secure and caring. I want them to know that we are doing our very best to take care of them. Please feel free to call me if you have any questions or concerns about your anesthesia 919-968-0611.

Pam Mills, CRNA

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Posted by luv2have-snowbaby (Member # 10410) on April 26, 2007 11:44 AM:

I have to agree with everyone here. It's your choice. I was just like you. But all the signs pointed to Dr.B. I have not even meet him yet but, the nurses a wonderful to speak to. Very informational. I have an idea of what web site you are referring to. I too thought about the other Dr. But after speaking with my Ob/Gyn gave her both web sites she and her experience said Dr. B.

Now the Wikipedia thing if you check out this. I found this Googling around:
http://en.wikipedia.org/wiki/Tubal_reversal

Hope it helps.
Angela VA

Monday, April 16, 2007

Wonderful Surgery Experience

Dear Dr. Berger & Staff,

Just wanted to take this opportunity while sending back my feedback sheet to thank you all so much for making our surgery experience so wonderful. I must say that when we first found the clinic the day before my surgery for my consult, we were surprised by the small appearance of the building. My husband & I expected a big sprawling clinic/hospital looking place. But once we entered into the reception area we were at ease. The receptionist was very kind & took a picture of us together so Dr. Berger would be able to “put a face with the name”. I thought that was great, that he thought enough of his patients to do that. We sat in the waiting area looking at & reading all the pictures of new babies & hundreds of thank you’s & blessings.

All the staff there at your clinic are very professional, patient & wonderfully friendly. I never spoke to one nurse who didn’t ask me if I had questions or concerns & they are all so fully capable of their jobs. Jennifer was the first one I had contact with via telephone when I first called to see about the procedure, processes & payment. She spoke with me a good while & never asked me to hold on and was very patient with all my questions. Rhonda was also when I had to call back a few days later about my blood work. My husband & I were very impressed with the whole setup of the clinic given our first outside impression. Everything was so organized, clean & efficient which made us less nervous & more comfortable. I liked the way you have the gown/robe packets put together in the bathroom where we change and the map to pin where everyone is from. That was really interesting to us to see where so many people have come from to your clinic. The recliners were comfortable to sit in & I thought it was a nice touch having the refrigerator with refreshments for the patients & partners.

When it was time for me to go back to surgery the nurses were so kind & it helped me to relax so much. I loved that the operating table was heated. Jan was with me & she massaged my arms & legs & kept me covered up so as not to “reveal” myself while I was positioning onto the table. That was very thoughtful & I barely remember anything else from then. I went right out with the ladies explaining to me what was going on..

When I woke up in recovery everyone was very attentive to myself & my husband. They even printed out some of the instructions in Spanish so my husband could read it himself & they would be sure he also knew what I needed to have for the next week or so after my surgery. We also think that the whole setup your clinic has with the hotel Sheraton was a great convenience. They were very helpful with giving me a room closest to the elevator so I would not have to walk too far after surgery & providing the shuttle bus for the drive to & from the clinic was one less thing to worry about with making sure you know how to get there & traffic. They also provided a little care package of food for after my surgery. The anesthetist’s were also very patient & informative along with Dr. Berger who was very patient with our questions & never made us feel he was rushing to get to the next patient. Laura, the nurse who came & checked on me at the hotel the day after was very nice & called to check on me at home also. Even Kathy, the nurse who did my ultrasound was great & gave me a copy picture to take to my doctor about a possible concern. All these things combined have made this a very wonderful experience & be rest assured that anyone I know who is looking to have this procedure done will be recommended to Dr. Berger & his great staff!!

I first found out about your clinic when I was researching tubal reversals via internet & came across your website. It was very straightforward, easy to understand & I liked reading some of the testimonials. Hopefully we will soon be sending out baby announcements ourselves. You will be some of the first to know. Thank you again & may God bless you all as you are blessing so many!

Sincerely,
Kathy & Joel C.

Sunday, April 15, 2007

Press Release - Tubal Reversal Study 2007

NEW STUDY SHOWS TUBAL REVERSAL SURGERY IS BETTER OPTION FOR WOMEN DESIRING CHILDREN AFTER TUBAL LIGATION

Six-year study shows tubal reversal surgery results in higher pregnancy and live birth rates and is less costly than IVF.

(CHAPEL HILL, NC) – Dr. Gary S. Berger, M.D., director of Chapel Hill Tubal Reversal Center, today released the most comprehensive study done to date of tubal reversal surgery and its resulting outcomes, showing that for the majority of women who have undergone a tubal ligation procedure and decide later they would like to have more children, tubal reversal surgery is a better option than in vitro fertilization (IVF).

“The results are clear – across all ages of women included, our results with tubal reversal surgery led to higher numbers of pregnancies and live births than standard IVF procedures.” said Berger. “Besides having higher success rates, the one-hour outpatient procedure is less than half the cost of an IVF cycle.”

“Many people, including doctors, mistakenly believe that tubal ligation surgery is a permanent method of birth control,” continued Dr. Berger. Tubal reversal surgery – a one-hour outpatient procedure – rejoins the separated segments of fallopian tube so that eggs can become fertilized and travel down the tubes to the uterus, allowing a pregnancy to occur naturally.”

When the tubal reversal statistics from Chapel Hill Tubal Reversal Center were compared with the latest national IVF statistics, pregnancy and birth rates after tubal reversal were higher than after IVF in every age group. Besides its higher success rate, the cost of the one-hour outpatient tubal reversal operation performed by Dr. Berger is less than half the cost of an IVF cycle.

The study report includes 3,139 patients who underwent tubal reversal surgery by Dr. Berger between January 2001 and December 2005. This is the largest and most definitive study in existence that provides information on the outcome of tubal reversal surgery.

At the conclusion of the study interval, 69 percent of the women in Dr. Berger’s study had reported pregnancies. The pregnancy rate ranged from 82 percent for women under 30 to 41 percent for women 40 years of age and older. The highest pregnancy rate (87 percent) was among women age under 30 after reversal of a previous ring or clip method of sterilization.

Dr. Berger, one of the pioneers of tubal reversal surgery, is a reproductive surgeon who specializes in and limits his practice to outpatient tubal reversal surgery.