Why She Chose Chapel Hill Tubal Reversal Center

Roslyn, a Chapel Hill Tubal Reversal Center message board member since 2008, is scheduled for tubal reversal surgery later this month. She posts her impressions of the staff on the message board, describing the staff members as polite, caring, and patient. Read more comments from patients on the website and on the Patient Satisfaction page.

This is topic Why did you choose CH? in forum Questions about Tubal Reversal at Tubal Reversal Message Board.

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Posted by WIMom27
I am about 90% sure I will be coming to Chapel Hill Tubal Reversal Center for my tubal reversal , but still have a few questions I'm trying to get figured out in my own mind. I would appreciate any of you ladies out there who are willing to share your reasons with me why you chose CH and how you have felt about your experiences with them. Thanks!

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Posted by christbride
The message board was the main reason i decided on CH. This was the only place i could get "real" feedback on everyone's experience and not just testimonials they posted on their site and the only site that gave live statistics on their results. and it was much cheaper than local tr places. and this is his specialty and he does so many surgeries a day i figured he must know what he's doing. Dr. Monteith was interning at the time i had my tr done. it was successful. i have a 8 1/2 month old baby girl. definitely the best decision i made.

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Posted by praying4more2009
I had a wonderful Experience with CH:)
When I started to do my research I just found myself drawn to this one.. maybe it was the online community and reading everyone's experience there and all the success stories. Everything I read was exactly what I got! Absolutely wonderful staff and service there. When I met Dr. Monteith I felt at ease..he was very understanding and also was honest about the fact that he did not know from reading my report if I had enough tube left without further testing..We chose to take our chances and I was happily surprised to have him tell me I had 5 &5.5cm left:)
What really made me decide on Ch was when I went to my own OBGYN and asked if he would reverse me and he said, 'yes i could, but I don't really recommend it at your age.. id suggest IVF.' I went home feeling deflated. The more I thought about it, I realized that yes my obgyn can do it..BUT he probably doesn't do them often.So maybe if I wanted the best chance, I should go somewhere that this is ALL they do. That was the biggest reason..they do TR everyday and that is ALL they do there. I had my TR done oct20-09

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Posted by Hopeful1970
I came to CH after 7 years of trying to get a reversal done through the military. I had great care at CH. Dr. Monteith gave me my life back. I had my TR done on 11/23/09. I have 7cm on my left and 5.5cm on my right ( tubal length ). You will enjoy the experience.
Sabrina

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Posted by Sally, RN
WIMom27--If you have any questions at all feel free to call our office and speak with any of the knowledgeable tubal reversal nurses . They will take the time that you need to get any questions answered. The message board is also a wonderful place for support and first hand information about how patients really feel about there care. December is a wonderful time to get your reversal done so you can have a happy new year in 2010.
Sally,RN

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Posted by Erika J, RN
We are here to answer any questions or address any concerns you may have. You can contact us for tubal reversal questions at 919-968-4656.
Erika J.

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Posted by GodisGood68
Hi, I have been on the message board since early 2008. The information and support we get from each other is phenomenal! The staff of Chapel Hill Tubal Reversal Center are very polite and caring. I'm having my TR Dec. 29th. Even trying to get all my bloodwork and medical information, they are very patient and polite every time I called or emailed with questions. When I told my GYN/OB my desires to have TR she did not know that I was looking at CH, and she referred them to me. How incredible is that!!! I am located in Bermuda. So, that is why I choose CH. Sorry for the long story, but I hope it answers your questions.
Roslyn

Is Pregnancy Possible After Endometrial Ablation

Pregnancy After Endometrial Ablation And Tubal Reversal

Dr. Charles Monteith, a microsurgeon at Chapel Hill Tubal Reversal Center, explains that many women will have both a tubal ligation and an endometrial ablation procedure. Some of these women will regret their decision and wish to become pregnant. and that a successful pregnancy is possible after an endometrial ablation; however, there are unique risks of pregnancy in women who become pregnant after ablation. Women who are considering pregnancy after an endometrial ablation need to be carefully informed about these risks.

Both uterine artery embolization and endometrial ablation are procedures to treat heavy menstrual periods. Although they both decrease bleeding, each procedure is uniquely different.

The uterine artery embolization is done by a radiologist in a radiology procedure room and involves blocking the uterine arteries to decrease blood flow to the uterus and decrease blood loss during the menstrual period.

An endometrial ablation is a surgical procedure done by a gynecologist either in the office or the operating room and involves removing the endometrial lining of the uterus. This also helps to treat anemia by reducing or eliminating blood loss during menstrual periods.

Both of the above procedures are designed to treat anemia and heavy menstrual bleeding. They each do this through a different process and pregnancy is possible after either endometrial ablation or uterine artery embolization. The purpose of this series of articles is to explain the risks of pregnancy after endometrial ablation.

Pregnancy And Endometrial Ablation Procedure

The goal of the endometrial ablation is to permanently remove the endometrial cells that make up the lining of the uterus. There are many different types of ablation procedures:

Laser ablation
Roller ball electrocoagulation
Transcervical resection (actual removal of the lining)
Cryoablation – Freezing. (Her Option)
Thermal ablation -hot water balloon (Thermachoice)
Thermal ablation -hot water (HTA)
Microwave endometrial ablation (FemWave)
Electrocoagulation (Novasure)

Although there are many different endometrial ablation techniques, these procedures are all intended to have the same end result: removal of the endometrial lining and a reduction in the amount of bleeding during a menstrual period.

Menstrual Period And Endometrial Ablation

Most endometrial ablations are not very effective and will not remove 100% of the uterine lining. A significant number of women will continue to have menstrual periods immediately after or within five years of an endometrial ablation procedure. These are the women who are most likely to be able to become pregnant.

Endometrial Ablation: Tubal Ligation or Vasectomy?

Pregnancy is possible after an endometrial ablation procedure, and, because of the possibility of pregnancy, most doctors recommend a permanent form of birth control in women who undergo ablation procedures. The most common procedures during or after an endometrial ablation are vasectomy or tubal ligation. Some women who undergo endometrial ablations will use a hormonal form of contraception or rely on the protection sometimes afforded by older age.

Menstrual Period After Endometrial Ablation

Women who have a menstrual period after an endometrial ablation can become pregnant and pregnancies after ablation have been reported in the medical literature.

Some women will accidentally become pregnant after an endometrial ablation. The majority of these pregnancies have been among women who were not using birth control or not using a reliable form of birth control or among those who have had a failed tubal ligation or vasectomy. Some pregnancies have been among women who have intentionally had either IVF or tubal ligation reversal.

Pregnancy is most likely to occur in women who have resumption in their normal menstrual cycles because these are the women who still have enough lining to create a menstrual period and support a pregnancy.

Endometrial Ablation And Tubal Reversal: Is Pregnancy Possible?

Many women will regret their decision to have a tubal ligation and endometrial ablation and will inquire about reversal. Most manufacturers of endometrial ablation devices and most physicians who perform endometrial ablations do not recommend becoming pregnant after an ablation procedure. Pregnancy is not recommended because of the higher risk of miscarriage and pregnancy loss.

Pregnancy after endometrial ablation and tubal reversal is possible but there are unique considerations regarding pregnancy after an endometrial ablation.

Readers are welcome to visit our Tubal Reversal Blog and read personal stories about tubal reversal and pregnancy success. We also invite readers to visit our Tubal Reversal Message Board and participate in ongoing discussions about pregnancy after endometrial ablation and tubal reversal.

My Space Video Interview WithTubal Reversal Staff

My Space video interview with Chapel Hill Tubal Reversal Center Staff
Meet the Chapel Hill Tubal Reversal Center Staff

CHTRC Webmaster | MySpace Video
Staff members at Chapel Hill Tubal Reversal explain their how they help make reverse tubal ligation safe, comfortable, and successful for women wanting a pregnancy after tubal ligation. Each staff member has expertise in caring for and performing outpatient tubes reversals. A high staff/patient ratio with one or two nurses devoted specifically to each patient’s care means women receive safe, personalized, professional care while they are joined by other couples who are at Chapel Hill Tubal Reversal Center to enable pregnancy after tubal ligation.

Tubal Reversal Surgeons Reverse Adiana Sterilization

Doctors at Chapel Hill Tubal Reversal Center become the first to reverse tubal sterilization by the Adiana technique

October 9th, 2009 (Chapel Hill, NC) – Julia Smith, RN, Nurse Administrator at Chapel Hill Tubal Reversal Center in Chapel Hill, North Carolina, today announced the first successful tubal reversal procedure to repair the fallopian tubes in women who have undergone the Adiana method of tubal sterilization. This is the first pregnancy after Adiana reversal for the newly approved sterilization system.

Adiana sterilization was approved for use in the US by the FDA in July 2009. The procedure can be performed in a physician’s office and involves using radio frequency energy to remove cells in the lining of a small area of the fallopian tubes nearest the uterus. The device itself is then implanted in this prepared area. The Adiana system is similar to the Essure sterilization method in being a non-surgical female sterilization method which promotes scarring to create a tubal blockage.

Dr. Gary S. Berger and Dr. Charles Monteith performed the reversal during a one hour and ten minute tubal surgery procedure. The healthy fallopian tubes were separated from the blockage and tubal implantation was performed through a newly created opening in the back of the uterus. Since the Adiana and Essure sterilization methods involve a small segment of the narrowest part of the fallopian tube, long tubal segments remain after the reversal procedure which is a major factor in tubal reversal success rates. The pregnancy success rates can be found in the latest tubal reversal study available at http://press.tubal-reversal.net/2009/pregnancy-rates-by-age-and-tubal-ligation-method.html

Dr. Berger and Dr. Monteith performed the tubal reversal procedure on a 35-year old woman who underwent sterilization by the Adiana technique as part of an experimental trial to test the new sterilization procedure six years ago. Although she underwent tubal sterilization intending for the procedure to be permanent, the patient’s decision to reverse the procedure was promoted by the unexpected and sudden loss of a child.

Chapel Hill Tubal Reversal Center is the only facility in the United States that specializes in the practice of tubal reversal surgery and repair of blocked fallopian tubes. Patients travel from across the US and from abroad for surgery at the specialty facility with its highly trained and experienced surgeons and staff. Additional information regarding tubal reversal surgery, Adiana reversal and Essure reversal is available at Chapel Hill Tubal Reversal Center, including profiles for Dr. Berger and Dr. Monteith, can be found on the website at www.tubal-reversal.net.

Tubal Reversal Pregnancy Study Report 2009

Study Shows Tubal Reversal Surgery is the Best Treatment to Have More Children After a Tubal Ligation

Dr. Gary S. Berger today reported the results of the largest study ever performed of tubal reversal surgery, involving over 5000 women. The prospective study concludes that tubal ligation reversal is more successful than IVF for couples wanting more children after a tubal ligation.

“A simple one-hour outpatient tubal reversal procedure is more successful and costs less than half than the widely used and more complex IVF treatment,” said Dr. Berger, Medical Director of Chapel Hill Tubal Reversal Center.

“With increasing divorce and remarriage rates, many couples want to start second families, even after women’s tubes have been tied. Most people, including infertility specialists, think of tubal ligation as a permanent method of birth control,” continued Dr. Berger. Tubal ligation reversal repairs the fallopian tubes to allow pregnancies to occur naturally again.

The Tubal Reversal Pregnancy Report 2009 compared pregnancy statistics from Chapel Hill Tubal Reversal Center with the latest IVF statistics in the US. Pregnancy and birth rates were higher after tubal reversal than after IVF for every age group.

The study involved 5,046 women who had tubal reversal surgery performed by Dr. Berger between July 2000 and June 2008. This is the largest and most detailed long-term study ever performed regarding tubal reversal surgery results.

At the conclusion of the study interval, 66 percent of the tubal reversal patients had reported pregnancies. The pregnancy rate ranged from 80 percent for women under 30 to 31 percent for women 40 and older. The highest pregnancy rate (90 percent) was among women under age 30 following reversal of a 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 ligation reversal. Eliminating the need for hospitalization was one of the main factors in the lower cost of the surgical procedure.

Tubal Reversal Pregnancy Study Report 2009

Tubal Reversal Informed Decision And Recovery

Chapel Hill Tubal Reversal Center (http://www.tubal-reversal.net) -- Dr. Berger discusses the issue of informed decision about tubal ligation reversal with his patient during her recovery just after her tubal reversal surgery. As a nurse herself, she points out how helpful it is to have a full understanding of the tubal reversal process to make an informed decision about it and why she chose tubal reversal vs IVF

Transcript of Video Interview With Dr. Berger

Dr. Berger: And briefly because of their ages they were told no you can’t and that was really not their place. That is not a decision that a doctor makes for somebody else. I mean that is a personal decision based on the concept of informed consent. Then I suggested we talk a little bit about it because to me that is a really important issue. And informed consent is not just the signing of a piece of paper where someone just sticks a piece of paper in front of you. It is a process of when someone calls or starts to seek information. We try to provide very comprehensive information about everything that we can think of that is related to tubal ligation reversal. All of the pros and cons, how it’s done, what are the various options. I mean in the terms of surgery the various types of surgical procedures, alternative treatments which involves in vitro fertilization or some variation of that.

Tubal Reversal Patient: Your website is excellent as far as finding out. I mean, I am a researcher. I will read something to death before I make a decision. And you do offer a lot of information on your website. And everyone was so knowledgeable too. I mean, I did have questions pop up and it was very easy to have questions answered. Even at home if I did think of something it was easy enough to find it on the website or to find someone that could answer it. And that is being accessible too and that is a really good thing.

Dr. Berger: That’s right it is pretty important and we have nurses generally we have two nurses. Well, during working hours we have a lot of nurses who work here. But, outside of work hours we have two nurses carrying cell phones and myself. And I try to be readily available by email. I check email everyday even multiple times throughout the day. But it’s interesting to me too like you are here this is now and we are sitting in the second stage recovery room. And I think I finished your operation around 11:00am.

Nurse: 11:07am

Dr. Berger: And it is now 12; 35pm, so this is within an hour and a half of surgery. I think one of the things that is important to me that I really try to ensure for patients is that not only is the surgery safe but I do everything I possibly can to make sure it is comfortable.

Tubal Reversal Patient: Nods head and answers yes.

Dr. Berger: Because one of the worst things about surgery is that it can be real painful and that’s one of the disadvantages of a surgical procedure and the recovery time it takes. I find it interesting and the reason I asked if you’d be will to talk about it because as a neonatal intensive care nurse you see things from both the patients perspective and as a nursing professional.

Tubal Reversal Patient: Some of the wonderful things you have are the pictures you have and the books in the waiting room and there are people who are wondering are really real and yes they are they are right in the books and that is a wonderful thing. And it really boosts you up a bit.

Dr. Berger: And that is the joy of the whole thing. And obviously, I want know I mean there are various reasons for it. And when it comes back to the issue of informed consent frankly I don’t see how anyone could undergo tubal reversal surgery unless they have a realistic idea of that the success is going to be. That is in the potential benefits and the potential risks. Well if we do not follow up on all the patients that have surgery and find out what the outcomes are how can provide that information? And I don’t know how to say it the sad thing or kind of disgraceful thing is that no one else does this. It does take a lot of effort admittedly. You have to be committed to maintaining that contact which is different then most surgical procedures where once the patient is recovered from surgery and they are no longer a patient. But, to me it’s the only sensible thing to do. It’s exciting to know what is happening. Intellectually, it is gratifying. And it adds useful information to the medical field but it’s absolutely essential for the patients when they are trying to decide what to do. If they don’t have that how could they really decide between IVF or tubal reversal or to go to this place or have a tubal reversal someplace else? These things seem just common sense.

Tubal Reversal Patient: And they are able to decide what to do. When I went to work and told them what I was going to do and they asked if it was going to work and I was able to give them that information because it was right there on the website and plus in speaking with you. I know everyone’s situation is different and every patient that comes through your door has a little bit of a different scenario why they chosen this and what’s going on in their lives and you are right in what you said informed consent is a very personal thing. But the question is will it work for me? And what are the benefits and what are the risks involved to me is I do this? Not just physically but emotionally and it is a big undertaking for anybody. And I really do feel like I was very prepared by you the staff and your website.

Dr. Berger: (To partner) And how about you? How do you feel about it?

Tubal Reversal Patients Partner: The full disclosure of knowing both sides of it it is not a used car sales pitch. It’s here what we offer and here’s the good, here’s the bad and you make the decision on your own. There’s no sugarcoating of anything to get business. You definitely give out the impression of you want people to come in knowing what they are getting into and that they are completely aware of every aspect and every side of it.

Dr. Charles Monteith, Tubal Reversal Surgeon

Interview with Dr. Charles Monteith
Tubal Reversal Surgeon at Chapel Hill Tubal Reversal Center

Charles Monteith, M.D. speaks about his education, training, and certifications. Dr. Monteith says he currently performs tubal reversals eight to twelve a week and the reasons women mention for wanting to have their tubes reversed. He says these include a new partner, or people have just changed their minds and decide they want to have more children. He adds a lot of women have experienced changes in their bodily functions after tubal ligation, and that patients refer to this as Post Tubal Ligation Syndrome.

Transcript of Video Interview With Dr. Monteith

Interviewer: Can you tell us about your medical school and residency training?

Dr. Monteith: I went to medical school in San Francisco, University of California in San Francisco and finished my MD degree there and then subsequently returned to the University of North Carolina, Chapel Hill to do my obstetrics and gynecology residency.

Interviewer: How long have you been performing reproductive surgery?

Dr. Monteith:I have been performing Gyn. surgery since 1997 but as of a year and a half ago dedicated myself exclusively to working with Dr. Berger and doing tubal reversal surgery.

Interviewer: And before you started working with Dr. Berger did women frequently ask for tubal reversal procedures was that something that something that came in your practice prior?

Dr. Monteith: As a generalist I did not see a lot of women that requested tubal surgery. However, our practice was a majority of young pregnant women. So I didn’t get a fair assessment of how many women were out there that wanted to have tubal ligations reversed. However I did have a partner that did perform exclusive GYN services she fairly often had requests or inquiries about tubal reversal surgery.

Interviewer: What made you pursue a certification in tubal reversal?

Dr. Monteith: I think I had had practiced high risk obstetrics and gynecology for a good seven years after I finished my residency and just one day I realized I needed to change what I was doing or I wasn’t going to last very long doing it. The way medicine has become is very high volume very stressful and little time with patients. I felt like I really wasn’t helping people to the best of my ability. Patients would come they would go. They would their insurance and have to go find another provider. People would come with job movement in the middle of pregnancy or leave in the middle of pregnancy and I just found that I didn’t get a lot of personal fulfillment out of it. I especially like my role as a tubal reversal provider because I like I’m being with a physician is supposed to be. I’m using my skills to help people to the best of my ability. And I especially feel because it’s not a widely offered service that I’m doing even better for a lot of women.

Interviewer: How many reversals do you perform each week?

Dr. Monteith: On average about eight to twelve a week currently.

Interviewer: What are some of the reasons women mention for wanting to have their tubes reversed?

Dr. Monteith: It seems like the most common reason is basically none of us can predict the future and most commonly it seems women find themselves in new relationships. Usually it is bad marriages, separations and divorce. And they find themselves with a new partner and just very strongly they would like to have children together. A close second to that would be to people that have just changed their minds and decide they want to have more children. And then a lot of women have experienced changes in their bodily functions after tubal ligation.

Interviewer: Are you referring to Post Tubal Ligation Syndrome?

Dr. Monteith- Ah yes, what most patients refer to as Post Tubal Ligation Syndrome.

Interviewer: And how frequently do you hear that as a condition that women feel they have developed?

Dr. Monteith- We hear it very commonly. There are probably a lot of women who come through here that never voice it or share it. But, at least in my experience here, I see a patient at least once a day if not every other day that has experienced worsened menstrual symptoms or bodily functions after a tubal ligation procedure.

Interviewer: And how much follow-up or are you able to follow-up after the surgery to see if that has improved?

Dr. Monteith: I am in the process of doing that now. Last year, we did a small case study on five women that had tubal ligations and experienced Post Tubal Ligation Syndrome. This summer it will be a full year and thus far in talking with them it seems at least about 70% of them have gotten better. Very frequently I am amazed that women post on the message board how much improvement they feel after they have reversal surgery.

Interviewer: How much contact do you have with patients after their reversal surgery?

Dr. Monteith: Most patients come from long distances so there is not a lot of direct contact but the most amazing thing is our tubal reversal patients seem to keep close contact by email and through electronic means. So, we hear from a large number of our patients.

Interviewer: What’s the best part of tubal reversal surgery and what you’re doing currently?

Dr. Monteith: The best part is really just using my skills to help a woman, a couple or a family to achieve what they would otherwise not be able to achieve and that is to add more children to their family or their relationship. Or to improve their perceptions about their body.

Interviewer: What do you like about Chapel Hill Tubal Reversal Center?

Dr. Monteith: The thing I like the most about this center and I come from my experience of working a large university and also from working at a large good quality hospital in Raleigh is that this center works with amazing efficiency. We take great care of patients. The staff seems to be real happy and motivated. And we are all dedicated to doing just one thing and that’s tubal surgery. And it feels good to work in a place with such high efficiency for the betterment of patients.

Interviewer: How does Chapel Hill compare to the in patient care of a hospital?

Dr. Monteith: There about the same as some of the best hospitals I have worked at and probably even better. Mainly because we are all focused on one thing and the staff really knows their jobs. And we are all dedicated to making that one goal happen, and that’s safe outpatient tubal repair surgery.

More Information about Dr. Monteith

The Cost Of Tubal Reversal Surgery

For many women and couples who are looking into tubal reversal surgery the cost is a big issue. In these hard economical times everyone is trying to cut corners. There are some surgeons that are very expensive and some do charge less for the tubal reversal surgery.

One of the biggest things to watch for when comparing the prices for surgery is that the price may be lower until you add in the other expenses. What many have been doing is stating a low price and then after adding in the price of the anesthesiologist and the hospital stay, which ends up being very expensive. Many do not realize this until they think they have all the money saved for the surgery and then go to a consult with the surgeon who will be performing the tubal reversal surgery and then are told the added in charges.

Read the rest of this article

Good Financial News for Tubal Reversal Surgery
Women desiring tubal reversal often find themselves being financially creative. The cost of tubal ligation reversal can range from $5400 to over $25,000, depending on where the operation is perform. Chapel Hill Tubal Reversal Center keeps the cost for tubal reversal to the absolute minimum to help women be able to afford the operation that will allow them to have more children. Many women wanting a baby after a tubal ligation share their ideas on the Tubal Reversal Message Board for overcoming the financial obstacles to having this life-giving procedure.

Tubal Ligation Side Effects

If you have been doing research about having your tubes tied before having the surgery, then you are smart. Most women, however, don't do any research. They just know it's the most popular form of permanent birth control and just go for it. After all their doctors have told them it's popular and completely safe. Unfortunately, many of them find out later, after the symptoms start, about some tubal ligation side effects called Post Tubal Ligation Syndrome.

But let's say you are looking for information ahead of the surgery and you have run across mention of post tubal ligation syndrome. Doesn't sound like much fun, does it? So you are probably wondering just who is at risk of suffering from this condition and what causes it. If you have already had your tubes tied and are suffering it, you may also want to know what can be done to relieve the problem which is below.

Who is at risk?

Risk factors that some study has been done on resolve down to two things - what type of tubal ligation you have and your age.

In an interview at the International Pelvic Pain Society conference with Dr. Ahmed El-Minawi, Ph.D., we learn that women who have had what he calls more destructive forms of having their tubes tied are the ones at higher risk to suffer from ptls. The methods which cause the most damage to the mid-segment of the fallopian tubes such as with the Pomeroy or Irving-type procedures fall in this category. Also included are the coagulation methods with a bi-polar coagulation, or as we laymen call it, cauterization, being the more destructive.

Additionally, women who are in the 20s when they have their tubes tied are at greater risk of having menstrual disorders. That's from one study which looked at women who had tubal ligation vs. those who did not and who ended up in the hospital with menstrual disorders. Women in their 20s were 6 times more likely to go. To put it another way, that's 600% over the normal population.

While looking at the above two paragraphs might make you think, "Hey, I'll just wait till I am 30." and to be sure to get rings or clips to tie your tubes, that just is no guarantee that you won't get post tubal ligation syndrome. Why? Well, that leads to the next part.

What causes post tubal ligation syndrome?

This part I have to start with a warning. We really don't know what causes ptls at this point in time. It really needs research, real studies, by researchers who don't go into these studies with the idea that ptls doesn't exist. I've read some of the abstracts and conclusions of studies already done and even when a study shows that something is going on, it's discounted on various grounds. As the old saying goes, "I'll see it when I believe it." Personally, I have just read too much from women who are suffering from post tubal ligation syndrome not to believe something is going on.

So the present theories, including from one doctor who was involved in this field for ten years, is that when the tubes are tied, the blood supply to the ovaries is damaged. It can even be cut off entirely which can cause ovarian isolation which leads to atrophied ovaries. When either of these happen, your body isn't going to get the right amounts of the hormones you need. Or you can get the right amount of one and not enough of another leading to hormonal imbalance.

The other theory is that even when the blood supply is just fine, damage is done to the receptor cells which can lead to this failing of the hormones again. These cells carry the messages about the hormones. Messages don't get through; hormones don't get through, at least not in the right amounts.

Basically, the main theory that however it is done, the hormones get all messed up which lead to a woman suffering a whole host of problems which make up the symptoms of post tubal ligation syndrome (check other articles about the list). This is why many women upon complaining to their doctor of their new symptoms end up on birth control pills. It's either that or a hysterectomy in most cases which leads to its own list of problems.

But if you really want to do away with ptls, your best chance of recovery lies in having a tubal reversal. Dr. Berger of the Chapel Hill Tubal Reversal Center began collecting statistics (only tubal doctor I know of who does this) when he realized how many women were coming to him for tubal reversals in order to relieve their symptoms of ptls. He can now say he has a 90% success rate in helping women recover from post tubal ligation syndrome.

What this means is that if you do go ahead with having your tubes tied and you end up in the unlucky 37% or so that have post tubal ligation syndrome, if you choose, you do have a way out. But please check more into ptls before you go ahead with your tubal ligation first.

Tubal Ligation Reversal Surgeons - What To Look For

For those who are looking for the right tubal reversal surgeon the choice is not always easy to make. Reading what other patients have to say can be very helpful and insightful.

Posted By Debby Verville Jun 19, 2009 at 10:53 AM

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For those who are interested in tubal reversal surgery many wonder what to look for in the surgeon. Many patients who actually write back and forth on message boards have shared what experiences brought them to choosing the physician that was right for them.

Tubal reversal surgery like most surgeries is something that when it is time to choose the physician you as the patient want to be 100% sure with the decision you have made. Being confident with your decision will not only put you at ease but you will have an understanding of what to expect in the long run.

For many who go through a surgery knowing that you can get in touch with the staff and surgeon should something arise means a great deal. This is one thing that the surgeons and staff at Chapel Hill Tubal Reversal Center pride themselves in. They believe that every question is important. If it weren’t important then why would someone ask it?

• When searching for the surgeon to perform tubal reversal surgery one of the best things that can be done is to talk to previous patients. This can be done by checking to see if the surgeon has a website. If they have a website look to see if they have a message board. In the message board look to see what the patients are saying and who may be asking questions and who and how they are being answered. Does the staff take the time to interact with the people asking questions? If so, are the answered in a friendly tone? Are the questions answered in a way that can be understood by someone not in the medical community?
• What type of pregnancy rates after surgery do the patients have? Is there any data to show the actual results? Any tubal reversal surgeon can proclaim that all of the patients that have been through surgery have had successful pregnancy but is there any evidence to back this up?
• Will the surgeon be honest with the patient in what to expect? The last thing people need is a surgeon to fill them with unrealistic expectations. Why have people believing something that may not happen? This is a ploy used by some just to make money.
• Do the staff and surgeons care about what they do? This is something that many of the former patients can answer. Dr. Berger and Dr. Monteith’s patients have written about this many times and continue to do so.

Is Tubal Reversal After Age 40 Possible?

Sandra Wilson asks "Is Tubal Reversal After Age 40 Possible?"

Sandra says most doctors have negative views about the likelihood of women becoming pregnant in the forties, especially if they have had a previous tubal ligation. The commonly recommended treatment is donor egg (using the eggs from a woman in her twenties) IVF.

Data from a study of tubal reversal patients at Chapel Hill Tubal Reversal Center, however, shows that pregnancy is possible for women in their forties using their own eggs and conceiving naturally after a tubal ligation reversal.

Of the 4025 tubal ligation reversal procedures done by Dr. Berger of the Chapel Hill Tubal Reversal Center from 2001 to 2007, 13% were for women wanting a pregnancy after 40. Of these 506 women, his 2007 study shows that 41% became pregnant following their tubal reversals.

Women age 40 and older, however, do have a higher miscarriage rate (approximately 50%) than younger women (35%). Nevertheless, this study shows that tubal reversal is a reasonable treatment option, and it is considerably less expensive than the complex treatment of donor egg IVF.

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Full text of Sandra's article:

There are a great many women who, after reaching the age of 40, then decide that they want to have more children although they have undergone tubal ligation. Today tubal ligation reversal to allow for pregnancy after 40 is becoming an increasingly common procedure. In one tubal reversal center alone during the period of 2001 to 2007, the surgeons carried out 4,025 tubal ligation reversals and 13% of these were for women over 40.

However, any woman who has undergone the original procedure to have her tubes tied must be aware that there are certain factors that need to be taken into consideration when thinking about having it reversed. The chances of a woman conceiving naturally once she is over 44 are greatly reduced. In fact, there is only a 5% chance of women over 44 conceiving naturally in the general population.

What these women who are seeking a tubal ligation reversal for a pregnancy after 40 need to be aware of is that not only are the chances of them becoming pregnant reduced, they also at a much greater risk of miscarrying when they do get pregnant. This concern along with related risk of chromosomal abnormalities means a woman seeking a tubal ligation reversal after 40 should be very aware of all the potential problems and be sure she considers all the alternatives.

For a woman who is trying to become pregnant when over 40 and after a tubal ligation reversal, there are certain things to do that can improve their chances. Below we look at just a few of these things.

1. It is important that before a woman tries to get pregnant after the reversal that she allows her body time to heal properly. One needs to remember that abdominal surgery has been carried out, so not only do the tissues but also the muscles of this part of the body need time to recover and repair.
2. By ensuring that your body has healed properly, you are providing it with the strength it needs to carry a new child. Therefore, it is a good idea for the woman to allow one complete menstrual cycle to take place before attempting to conceive after undergoing tubal ligation reversal surgery.
3. Another thing the woman should do which will help when it comes to a pregnancy after 40 is to track her menstrual cycle. The most effective and efficient way of doing this is by using an ovulation prediction kit, which you can purchase from your local drug store or online. By knowing when ovulation is taking place, the couple can then determine when is the best time to make love to improvetheir chances of conceiving the child they want together.
4. Lastly, once the woman thinks she is pregnant, she needs to follow closely the pregnancy protocol that her surgeon has established to ensure a healthy pregnancy and to be sure that the potential problems, such as ectopic pregnancy, have not happened.

Of the 4025 tubal ligation reversal procedures done by Dr. Berger of the Chapel Hill Tubal Reversal Center from 2001 to 2007, 13% were for women wanting a pregnancy after 40. Of these 506 women, his 2007 study shows that 41% became pregnant following their tubal reversals. Check out the blog at his website and learn more about the concerns for women becoming pregnant after 40 following a tubal reversal.

Pregnancy After Tubal Reversal Surgery

Sometimes, you get thrown a curve. Some time back you had your tubes tied but now you've changed your mind and have had or will have a tubal reversal so you can conceive another child. Once the operation is done, all you have your mind on is trying to conceive and have a pregnancy after tubal reversal surgery. However, you shouldn't get ahead of yourself. Here are a few tips and facts to help you out while trying to conceive.

Begin by realizing it takes time to get pregnant. During the time that nature is taking its course, you will find some of the following tips pertinent but let this one fact here help you maintain a positive mindset. During a 2007 study of his tubal reversal patients, Dr. Berger found that the vast majority of them got pregnant within 13 months. Yes, this does mean that there are a few who take longer. But I hope it will help you to know most do have a pregnancy after tubal reversal surgery within about a year.

Before you begin trying to conceive, let your body heal after the tubal reversal. You had abdominal surgery and all those muscles and tissues need to heal. After all, you want your body strong enough to carry that new child. Dr. Berger says to wait at least one cycle before working on that pregnancy after tubal reversal surgery.

Don't rush into having a HSG done to check if your tubes are still blocked. Not only are many HSGs done incorrectly or the results read wrong, you are taking a chance on messing up that tubal reversal. When a HSG is done, it washes "stuff" or debris from the uterus up into the fallopian tubes. This debris can actually cause an infection and/or tubal blockage. It would be a shame to mess up repaired tubes like that and defeat the purpose of working on that pregnancy after tubal reversal. However, when you do get one done, relay it to Dr. Berger so he can read them and provide you with a proper reading if that is possible.

This next tip is rather simple and one your tubal surgeon will probably relay to you as a way of tracking your cycle. Get an ovulation predictor kit. Use it to know when you ovulate so you will know the best time to work on trying to conceive.

Now this last tip is more to relay a fact to you so you will know what may happen and to try to keep you from becoming very upset. MedicineNet.com states that about 50% of all pregnancies end in miscarriage. The general population of women don't always know when this happens for a couple reasons that are related. They don't track their cycle as carefully as you do and the miscarriages can happen very close to menstruation beginning. They just think Aunt Flo came a little early this month. You, however, will be aware of miscarriages that do happen. This is not to say you won't be successful quickly when you are trying to conceive, but it could take a little longer just because this is what can happen.

As a matter of fact, some of Dr. Berger's and Dr. Monteith's patients do achieve a pregnancy after tubal reversal so quickly, it's like they couldn't have even started working on trying to conceive. They get pregnant within just a month or a couple weeks following the surgery. So don't let the above information overly concern you but do let the tips help you through to that wonderful new baby you will be holding one day following your tubal reversal from the Chapel Hill Tubal Reversal Center.

More information on Trying to Conceive After Tubal Reversal Surgery

Tubal Ligation Reversal After Age 40

The tubal reversal doctors at Chapel Hill Tubal Reversal Center have writen a series of articles about the concerns of women over the age of 40 who are considering options for becoming pregnant after tubal ligation.

• Tubal Ligation Reversal After Age 40 | Introduction
  Monday, 26 January 2009 11:36 PM
  This series of articles will discuss adoption, in vitro fertilizaiton (IVF), and tubal ligation reversal. Statistical data and patient submitted stories will also be presented during this series.


• Tubal Ligation Reversal After 40 | Pregnancy and Infertility
  Friday, 30 January 2009 10:44 AM
  This article on the Tubal Reversal Blog from Chapel Hill Tubal Reversal Center discusses the impact of age upon pregnancy or infertility. Dr. Charles Monteith discusses his experiences practicing high risk obstetrics and the concept of advanced maternal age.


• Tubal Reversal After Age 40 - Adoption
  Tuesday, 3 February 2009 9:27 PM
  This is the third article in a blog series dedicated to women over the age of 40 with tied tubes and who are considering alternatives to become pregnant. This article provides a brief overview of adoption. We discuss the benefits and some of the risks of the adoptive process. Readers are encouraged to leave comments on the Tubal Reversal Blog and/or the Tubal Reversal Message Board.


• Tubal Reversal After 40 - Benefits
  Saturday, 7 February 2009 1:45 AM
  This is the fourth in a series of articles for women 40 and wanting to become pregnant after tubal ligation. This article describes the multiple benefits of tubal reversal compared with IVF (in vitro fertilization).


• Tubal Reversal After 40 | Risks
  Wednesday, 11 February 2009 5:14 AM
  The tubal ligation reversal experts of Chapel Hill Tubal Reversal Center provide a detailed list of the risks of tubal ligation reversal surgery in part four of a series of articles dedicated to women over the age of 40 who may be considering tubal ligation reversal. Using their extensive patient database, they provide estimates of the risk of each occurrence so patients can evaluate whether tubal ligation reversal is the right choice for them.


• Tubal Ligation Reversal After 40 | Tubal Reversal Process
  Friday, 13 February 2009 8:24 AM
  This is the fifth article in a series devoted to women over the age of 40 considering tubal ligation reversal surgery or other alternatives for having more children after a tubal ligation. This article describes the process involved in scheduling an outpatient tubal ligation reversal at Chapel Hill Tubal Reversal Center.


• Tubal Ligation Reversal After 40 - IVF Overview
  Tuesday, 17 February 2009 10:23 PM
  The tubal reversal doctors at Chapel Hill Tubal Reversal Center provide an overview of the process of in vitro fertilization (IVF), egg retrieval and intrauterine insemination and also discuss the application of these reproductive techniques in comparison with tubal ligation reversal.


• Tubal Reversal After 40 : IVF Risks
  Tuesday, 24 February 2009 12:57 PM
  IVF is widely accepted as a treatment for infertility for many causes including blocked or tied fallopian tubes. To maximize the pregnancy rate, it is a common practice to implant multiple embryos. This leads to the risk of multiple gestation, which occurs in 1 of 3 IVF pregnancies. The recent birth of octuplets in the US is a dramatic example of the risks of IVF.


• Tubal Reversal After 40 - IVF Benefits
  Friday, 20 February 2009 12:06 AM
  This blog article from the tubal reversal doctors at Chapel Hill Tubal Reversal Center describes the unique medical situations in which IVF has demonstrated benefits in assisting couples dealing with infertility. When the only cause of infertility is a tubal ligation, then tubal ligation reversal is the better treatment option for most couples.

IVF or Tubal Reversal?

Pregnancy After Tubal Ligation: IVF or Tubal Reversal?

A Chapel Hill Tubal Reversal patient, Cyndi, describes to Dr. Monteith how she was trapped in an abusive marriage and had a tubal ligation. After divorcing and meeting her current partner, Steven, she wanted to have another child with him. She then describes being talked out of tubal ligation reversal and into IVF by an infertility specialist, only to discover that IVF is illegal for unmarried couples in the state of Arkansas.

The following replies are from those posted at IVF or Tubal Reversal in forum After Tubal Reversal at Tubal Reversal Message Board:

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Posted by cindy0714 (Member # 13204) on January 06, 2009 08:13 PM:

This story is so familiar. My husband and I were also told our chances would be better through IVF than tubal reversal. IVF failed and broke our hearts. Now here we are 4 years later at CHTRC. I will be having my TR in March. Good Luck to you Cyndi.

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Posted by magdvn (Member # 12680) on January 06, 2009 11:30 PM:

I was told by a fertility specialist that IVF was a better option for us since I was almost 40 and would most likely only want one more child. My husband and I were led to believe that since I had had no problem getting pregnant in the past and he had no abnormal tests that we were almost assured to get pregnant. After $15,000 and no pregnancy (and no frozen embryos to try again) we were very disappointed.

We decide to have TR done because at least then we could try every month instead of a one time deal. I wish we would have done the TR much earlier and instead of IVF.

Merill

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Posted by pam mills (Member # 617) on January 07, 2009 05:32 AM:

Thank you ladies for your input. As your stories confirm, this issue is more common than we like to think. Many people are not even aware that tubal reversal is an alternative to IVF. I am so happy that you have found your way to Chapel Hill Tubal Reversal Center and I look forward to meeting you when you arrive in Chapel Hill.

Pam Mills, CRNA

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Posted by Martha, LPN (Member # 12781) on January 07, 2009 09:03 AM:

Thank you for this blog Dr. Monteith. We get frequent calls where we explain to women that with tubal reversal surgery, once the tubes are repaired, the chance of pregnancy can occur each month naturally. With IVF, medications must be administered by injection and a minor surgical procedure is performed each time pregnancy is attempted. Compared with current national IVF statistics, tubal reversal surgery at Chapel Hill Tubal Reversal Center has a higher pregnancy rate and it is more affordable than IVF.
Martha
Martha

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Posted by BirthdayBaker Judy (Member # 10176) on January 07, 2009 05:13 PM:

Just wanted to add a bit of my story for those over 40. I was 41 when I had my TR and 42 with my perfectly normal PG and delivery.
Judy
TR 10/16/2006
PG --1st try BFP 2/22/07
Delivery 11/2/07 baby boy 10# 7oz and 22.5 inches.
Vaginal delivery -- no pain meds.

Baby Joey is approx. 27# and 33" today at 14 months old. He's walking, reading words, knows colors, and numbers but isn't forming and using words just yet. He was tongue tied at birth and it took us 6 months to find a DR that would fix the issue. (This is a common family birth defect for me.)
I wish you all our same success.

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Posted by mommeeof3 (Member # 11929) on January 07, 2009 06:33 PM:

I think tr and ivf are both wonderful. I did tr first to end up with ectopic and after months of ttc that's all I got. To me with ivf you have 2 be a good candidate 4 it. I did it once transferred 2 eggs and I am currently 15weeks pregnant with twins.I don't regret either decision that I made cause the tr was about being whole again and that's how I feel WHOLE! We try and we get errors. I wish you all happiness with your decisions.

More information about IVF vs Tubal Reversal