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.

Chapel Hill Surgeon Completes First Tubal Reversal Fellowship

CHAPEL HILL – Dr. Charles W. Monteith completed the first tubal reversal fellowship offered at Chapel Hill Tubal Reversal Center. This is the only known fellowship of its kind.

Dr. Gary S. Berger, medical director and world-renowned tubal reversal surgeon, presented the certificate of completion in a private ceremony at the Chapel Hill center.

Monteith began his fellowship training in January 2008, and has assisted in more than 100 tubal reversal procedures under the guidance of Dr. Berger.

“Dr. Monteith’s experience as a gynecologic surgeon and his dedication to achieving the best patient care made him the ideal physician to complete this fellowship program,” said Berger. “He is the first doctor ever to be certified in outpatient tubal ligation reversal surgery. And I welcome him as a colleague at the Tubal Reversal Center.”

As a tubal reversal specialist, Monteith plans to keep tubal reversal surgery a viable option for women wanting to have another baby after tubal ligation surgery.

“I am very fortunate to have been invited into and accepted by the staff and family of Chapel Hill Tubal Reversal Center,” Monteith said. “I feel like I have arrived home.”

Dr. Monteith graduated summa cum laude from Xavier University in Louisiana. He attended medical school at the University of California at San Francisco where he received a Howard Hughes Medical Research Fellowship used to conduct research in molecular genetics.

After completing his residency in obstetrics and gynecology at the University of North Carolina at Chapel Hill, he accepted a clinical assistant professor position with the department of obstetrics and gynecology in 2001. He also served as assistant professor in obstetrics and gynecology at Wake Medical Hospital in Raleigh for seven years where he practiced high-risk obstetrics and advanced surgical gynecology.

To learn more about Chapel Hill Tubal Reversal Center, visit www.tubal-reversal.net.

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Contact information:
Lisa Hourmouzis, RN
919.968.4656 office
252.339.2322 mobile
LisaH@tubal-reversal.net

Sally Muncy, R.N. Tubal Reversal Operating Room Nurse

Meet Sally, a Tubal Reversal OR Nurse The team at Chapel Hill Tubal Reversal Center wants you to feel comfortable during your time with us. Sally Muncy, RN, an operating room nurse at Chapel Hill Surgical Center, describes what to expect the day of your surgery, and how she plays a part in your tubal reversal care in her latest tubal reversal blog. From preoperatively to recovery, Sally is there for you.

"Dr. Berger has asked me to give a short description of what I do as an Operating Room Nurse so that you will feel that you know me when you come here for your tubal reversal surgery. I am a nurse who accompanies you to the operating room once the preoperative nurses have admitted you and taken care of all your physical as well as emotional needs. I am there for you to make sure that you are comfortable and have no last minute questions or misgivings.

One more time I will check your name on your name band and ask you about allergies and if you have eaten. I will ask you to use the rest room to empty your bladder as Dr. Berger does not use any bladder catheter in your bladder during surgery. I’m not asking these same questions that the other nurses have ask you because I don’t know the answers, but ask them only as one more opportunity to avoid a mistake about something you may have forgotten to mention."

In The Operating Room

"In operating room, you will be made comfortable and warm and everything that is being done will be explained to you. I realize this is a little frightening since everyone in the operating room wears a mask, gloves and gown for your protection. This brings up another point about who will be in the operating room with you. As I said I will be at your side the whole time. There will also be an anesthesiologist or anesthetist, a surgical assistant, and a surgical scrub technician (the person who is responsible for all the sterility of the surgical equipment and for seeing that Dr. Berger has the instruments as he needs them when he is concentrating on surgery). The only other person present is Dr. Berger.

For those of you (and there are many) who have a concern for modesty in the operating room, you really have nothing to worry about. After the surgical area is cleansed you are covered from head to toe. There is only about an 8 inch by 3 inch window of skin exposed on your abdomen. Many ladies also come for surgery while having their menstrual period. This also is handled very discreetly. You will keep your underwear and pad on until the last minute and then you can remove them in the bathroom and we will have a pad on the bed for you. I really want to impress upon you that from the time you walk in the front door to when you leave after surgery you will be treated with the utmost respect and dignity.

Once you are settled in the operating room you go off to sleep fairly quickly after being attached to heart monitors and a final safety check being done. One more time every staff person in the room checks your name, allergies, and other important data regarding your health. At this point everyone takes their designated position in the room and like a finely choreographed dance surgery begins. Because of keeping sterility in the room, no one can touch another person so each one has to know exactly what they are doing and where the other four people are.I am the one who keeps computer records of anything pertinent to your surgery while Dr. Berger dictates in detail. I am also responsible to see that everyone has the sterile equipment, medications, irrigating fluids, or anything else that needs to be brought in to the operating room. And finally I perform, with the scrub technician, a counting of all the instruments and dressings that are used during surgery. This count is also done before you enter the room and two more times. The final count must match exactly. This avoids any concern of a lost instrument or dressing. This is to insure absolute safety. "

On To The Recovery Room

"When Dr. Berger finishes surgery I will put a small dressing on your abdomen. Surgical time will be recorded and you will soon wake up and move back to your original bed. It is then my pleasure to return you to the recovery room where your nurse will greet you and I will bring your family member in to sit with you.

I just want to assure you once again that you will be in good, safe hands throughout your tubal reversal surgery. Every staff member at Chapel Hill Tubal Reversal Center and Chapel Hill Surgical Center is there to meet your needs and we are honored that you have put your trust, first in Dr. Berger, and then in everyone else who has any part in your care. "

Sally Muncy, R.N. Operating Room Nurse Chapel Hill Tubal Reversal Center

6 Responses to “O.R. Nurse”

Ericka Says: June 27th, 2008 at 6:17 am Sally, this is a wonderful introduction. Thank you. I’m sure it will bring comfort to anyone who wonders what goes on in the OR. It is comforting to know that each and every staff member at Chapel Hill Tubal Reversal Center is a highly trained professional who has the patients’ best interests at heart. That is one of the things that makes this the best place for tubal reversal surgery and why women come here from all over the world.

Rhonda Brown RN Says: June 27th, 2008 at 7:12 am I know that this will bring comfort to each and every person that reads this. I know it will hellp answer lots of questions and bring a calmness to those who are wondering what exactly goes on in the operating room. This is just another example of exceptional patient care that is offered by the staff at Chapel Hill Tubal Reversal Center.

Jennifer Okun Says: June 27th, 2008 at 8:15 am Thank you for the very descriptive and informative post, Sally. You give a clear understanding of what patients are to expect during surgery. I hope all our patients take the time to read our blog - especially before they come here for their surgery. If they do, they will definitely feel more comfortable about what they can expect during their experience here.
Stephanie, RN Says: June 27th, 2008 at 12:16 pm Thanks Sally. This will help patients understand the role of a circulating nurse and help calm their fears about why and how certain things are done.

Sarah Meachem RN Says: June 27th, 2008 at 2:05 pm Sally’s excellent description of her role as an OR nurse should definitely alleviate patient fears about the OR and general anesthesia. Patients at Chapel Hill Tubal Reversal Center are always in capable hands and receive the best possible care.

Andrea Says: June 27th, 2008 at 5:57 pm Thanks so much for the description, Sally! I can’t wait to meet you, and the rest of the staff. I am scheduled on 7/30. Thanks so very much for taking the time to help ease our fears…one would think that after 2 vaginal births and 2 c-sections, there would be nothing left to fear…not the case!
Thanks again, and God Bless.

Pathology Reports Before Tubal Ligation Reversal

At Chapel Hill Tubal Reversal Center, we want to maximize the chances for pregnancy after tubal ligation reversal for all of our patients. One step that is helpful in planning for a tubal reversal procedure is examining the pathology report from a patient’s medical record. Pathology reports can provide critical information to a tubal reversal specialist since they convey additional information beyond what is contained in the operative report describing the tubal ligation.

What is a pathology report?

A pathology report- sometimes shortened to ‘path report’- is a typed report from a pathologist (doctor who studies healthy and diseased tissue) that describes the removed tubal segments. Usually when tissue is removed by a surgical operation, it is sent to a pathologist for examination. After this examination, a pathologist will create a typed report describing what was observed.

When a tubal ligation and resection procedure has been performed, a segment of fallopian tube was removed and most likely sent to a pathologist. Therefore, a pathology report should exist in the patient’s medical record. When a sterilization has been performed by tubal electrocautery or with tubal clips or rings, there will not be a pathology report because no tubal tissue is removed with these tubal ligation methods.

A pathology report will help our tubal reversal doctors determine exactly what was done during a ligation and resection procedure and what your chances of tubal reversal success will be.

Examples of Pathology Reports After Tubal Ligation

Here are some examples of what the pathology reports may show after a tubal ligation and resection:

Scenario 1
Operative note states, “A standard ligation and resection was done.” Pathology report states, “Two 1.5 cm isthmic sections of fallopian tube were examined.” In this case, the pathology report confirms that small amounts of isthmic tubal segments were removed and the chance of successful ligation reversal is very good.

Scenario 2

Operative note states, “A bilateral ligation was done…tubes were resected.” Pathology report states, “Two 4 cm sections of fallopian tube were examined and fimbrial ends were present on both sections.” In this case, the pathology report demonstrates that the patient has had a fimbriectomy. We would advise the patient that fimbrectomy reversal will be the appropriate procedure to reverse this type of tubal ligation.

Scenario 3
Operative note states, “A typical bilateral tubal ligation was done.” Pathology report states, “Two 7 cm section of fallopian tubes were examined.” In this case, the pathology report shows that large amounts of tubal length were removed. This is not a typical bilateral tubal ligation, and the chance of a reversing tubal ligation is remote. In this case, we would advise the patient that IVF would be a better treatment option for her than tubal reversal surgery.

Get Expert Opinion

As tubal reversal experts who specialize in ‘untying tied tubes’, we have found that most tubal ligations are reversible. Any patient considering ligation reversal should send us a copy of their operative reportand, if ligation and resection was done, a copy of the pathology report. We will review these reports, without charge, and provide the best recommendation for becoming pregnant after tubal ligation.

Submitted by Dr. Charles Monteith
Chapel Hill Tubal Reversal Center

Tubal Reversal in Canada

This is topic New with questions on the Tubal Reversal Message Board.

Posted by hopefulforfour (Member # 12046) on February 11, 2008 10:00 AM:

I am new here, well I have been reading for a while but just registered. I got a tubal (the rings, but not cut and burnt) in November 2005. The reason was that I had had 6 miscarriages. The last was at 3 months. Found out that it was low progesterone. But, my emotions got the best of me and I decided a few days after my last miscarriage to get a tubal. My miscarriage was on Sept 18, 2005 and I was getting my tubal on November 24, 2005. I regret it with every inch of my being. I would love to have one more baby. I have three ages 8,7 and 4. I should also say that I just turned 27 so age is in my favor I imagine.
My questions:
I am in Canada and was wondering why people are choosing to see Dr. Berger instead of getting it done in Canada. I am definitely getting the reversal but I am investigating the best options before I decide where to go.
Cost: For those in Canada, is it not cheaper to get it done here instead of with Dr. Berger? I am just wanting to know why you chose to go to the states as I will get a better idea of where I would like to go.
I just got the clamps (rings) so are there quite a few success stories with getting pregnant after? I know that if they are cut and burnt I am sure that the chances are not as great as the rings.
Also, my specialist that did the tubal told me that the rings would cut off circulation and would eventually make my tubes split apart. Is this true? Or has anyone heard of this?
Ever since my tubal I have had wicked pain at ovulation and right before my monthly. I am sure it is because of the clamps. My regular doc says he thinks I have endometreosis. I am actually going for an ultrasound today to check for that. I am sure that it is just the clamps. I wonder if surgery cost would be covered if the clamps are being a problem. Probably not!
Also, I have been reading about bmi. That is not a problem for me as mine is aroud 30. But, I am curious as to why that matters.
Thanks for taking the time to read.


Posted by in-Gods-hands (Member # 11795) on February 11, 2008 10:49 AM:

Well I do not live in Canada but the reason we choice to look to Dr.Berger for a TR is because of his studies in to this, his care of every woman that goes to him, and the fact that he is well known and only does TR's. I did not have the rings but I too have had the pain right before my AF and it is all because of the blood flow being cut off my doctor told me. So getting the TR would restore that. The getting pregnant after a TR if you had the rings I can not tell you. Our bodies are all different so it all depends on what your tubes are like after the TR I would think. Dr.B has things posted about this on his site. The BMI is important when it comes to putting someone to sleep and how much body fat the doctor has to go through to get to the tubes to repair them. This is what my doctor told me. I hope I was at lest a little help. If you want to come in to the waiting room part 42 and jump in and start asking ?'s the lady's will gladly answer. I will be praying for you. Miranda


Posted by Dr. Monteith (Member # 11996) on February 13, 2008 11:10 AM:

Hi- I thought i would jump in quickly.

The Chapel Hill Tubal Reversal Center is the only center in the United States which specializes in the reversal of tubal ligation. They don't do them periodically or on the third Thursday of every fourth month- instead every day, 5 days a week and every month of the year. The center keeps comprehensive statistics and follow-ups on patients for at least 12 months after the surgery so the success numbers are real and verified.

Also people really love to come to Chapel Hill to experience Tar Heel basket ball and to see the birth place of Air - his Highness- Micheal Jordan!

To have any permanent sterilization the tube must be separated. They can be ligated (tied), cut, and then they can be cauterized (fancy medical way of saying burnt)- this causes the tubes to close and separate. The rings and clips achieve the same result but through different mechanisms. These devices put so much pressure on the tube in a small area which causes the blood supply to stop to that area. This causes - avascular necrosis- or more simply, causes the tissue to that area to die and the tube separates and heals itself over. The benefit to the rings and clips is they are both very effective (low rates of failure and ectopic pregnancy) and minimal amounts of tubes are destroyed and reversal is theoretically easier.

Pain after ligation. Rarely do the devices cause pain after ligation. I have occasionally seen a rare patient in which the actual clips were the cause of the pain which resolved when the clips were removed.

It is possible you could have endometriosis but more commonly pain and cramps are due to other conditions such as adenomyosis- or just worsening periods as you get older (I am not calling you old-okay!). Patients after tubal ligation stop hormonal methods which usually make cramps and pain better- this is why some people have the perception that things got wore after the ligation. Some of the patients at the center have post tubal ligation syndrome and seek reversal for this reason.

More Information on Tubal Reversal in Canada

Why Choose Dr. Berger

Chapel Hill Tubal Reversal Center is the only medical facility specifically for tubal ligation reversal surgery. We provide the most detailed information about tubal reversal available from any doctor, hospital, or medical institution. Let me explain how we are able to do this.

Electronic Patient Database

Keeping track of patients following surgery makes excellent sense from a clinical point of view. Continuing follow-up after surgery helps ensure the best care for each patient and allows us to evaluate the success of tubal reversal surgery and the care we provide. Setting up and maintaining a system to ensure ongoing follow-up is not usually found in a private medical practice since this is costly and time-consuming and requires staff knowledgeable in database management. Regardless of the cost and time requirement, Dr. Berger has made it a priority because of his commitment to giving patients all of the information they should have in order to make an informed decision about tubal reversal surgery.

At Chapel Hill Tubal Reversal Center, we have a computer system where every nurse enters patient information before, during, and after their surgery. In fact, all 11 of our nurses contact patients, record data and make daily entries into computerized records. With this follow-up information, we can analyze and report accurate statistical data about the long-term outcomes of tubal reversal procedures I have performed.

Information Sources

The patient follow-up system consists of information collected in many different ways and includes a minimum of 6 calls or e-mails to the patient in the first year following surgery.

1. Post-operative nurse visit the morning after surgery;
2. Telephone follow-up on the second postoperative day;
3. Telephone follow-up on the third postoperative day;
4. E-mail questionnaire at two weeks;
5. Telephone contact at 6 months;
6. Telephone contact at 12 months.

Other information is collected and recorded any time we communicate with patients post-operatively. These contacts are usually initiated by patients to report pregnancies and the outcomes of pregnancies. When patients report new pregnancies, we request that they complete a Pregnancy Report Form. Each week, we summarize the new pregnancy results in the Weekly Pregnancy Report Forum of the Tubal Reversal Message Board and also give more details in the Weekly Pregnancy Announcements.

In summary, after reading our information and statistics and comparing it to what might be available from other doctors, we believe patients will recognize that Chapel Hill Tubal Reversal Center is the only facility where accuracy of information is considered to be a priority and sharing it with prospective patients is considered to be a necessity. Providing facts rather than offering misleading or speculative statements about tubal reversal success is one mission of our practice. We believe this is the right thing to do.

I hope this information is helpful to you as you consider whether tubal reversal surgery is right for you.

Julia Smith RN 919-656-8204

New To The Tubal Reversal Message Board

The Tubal Reversal Message Board is provided by Chapel Hill Tubal Reversal Center to allow women to communicate with each other about tubal ligation reversal. This excerpt is a good example of how women support and inform each other on the Tubal Reversal Message Board regardless of where they are from. Many women might feel they are alone in their desire to have another baby after a previous tubal ligation, but when they participate in the message board they realize that they are not alone at all.

Tubal Reversal Forums:

New Message Board Members for new members of the Tubal Reversal Message Boards.
Questions about Tubal Reversal for discussing questions about tubal ligation reversal.
Preparing for Tubal Reversal for those planning or preparing for their tubal reversal by Dr. Berger.
After Tubal Reversal for those who have already had their tubal ligation reversal by Dr. Berger.
Weekly Pregnancy Reports weekly pregnancy reports for patients of Dr. Berger.
Tubal Reversal Cost and Financing for discussing tubal reversal cost and financing.
Age and Tubal Reversal for discussing age and tubal reversal.

Tubal Reversal Information

How Do I Determine Which Tubal Reversal Information Is Accurate?
A member of The Chapel Hill Tubal Reversal Center Message Board posts her concerns that she has read a lot of conflicting information about the best tubal reversal techniques. Members of Dr. Gary Berger's staff - as well as other patients - offer information and encouragement. On the Internet, claims about tubal reversal pregnancy rates are often made without supporting information or documentation - such as a description of the patient population, study method, and follow-up interval. Most Internet sites about tubal reversal do not provide any factual data at all. Any doctor may say that his patients have a particular success rate, but supporting the claim with actual data involves considerable effort. Performing a follow-up study such as the one Dr. Berger compiles requires keeping an accurate record of patients and their findings, as well as maintaining ongoing patient contact to determine the outcomes of treatment. Without this detailed type of information, the accuracy of any claim of success rates should be questioned.

The following is topic Other websites in forum Preparing for Tubal Reversal from the Tubal Reversal Message Board:
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Posted by Impatient (Member # 5526) on November 27, 2007 03:00 PM:
I have been looking at this board and other TR sites for a long time and wonder why their seem to be so many difrent stories on the best way to do the surgery, dye tests, no dye tests, 3 layers or 2. Honestly, it seems that some people are just trying to throw out stuff to run people off or to be misleading. How should me and my dh know what is right?
Carrie
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Posted by CarlaJo (Member # 10380) on November 27, 2007 03:04 PM:
By the statistics of pregnancy and the recovery time. Dr. Berger and his staff are awesome! I did my research also, and he had the best stats for my age and type of ligation.
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Posted by Julia Smith, RN (Member # 10) on November 27, 2007 03:07 PM:
Hi, Carrie. I was asked this same question just a few days ago and do have e-mail requests with this same question fairly frequently. I usually respond that the "three layers are better than two" theory is just the opinion of one doctor on the internet!
Dr. Berger sews the muscular and outer serosal layers together but not the inner endothelial layer as this may increase the risk of scar formation within the tubal lumen. In his opinion, this is the best approach. The suggestion I always make is to read through the testimonials from our patients. All of those women had surgery performed by Dr. Berger using the microsurgical techniques he pioneered -- with pregnancy rates near 80% in our latest follow-up survey. This is a clear indication that his techniques are successful and result in pregnancies!
On the Internet, claims about tubal reversal pregnancy rates are often made without supporting information or documentation - such as a description of the patient population, study method, and follow-up interval. Most Internet sites about tubal reversal do not provide any factual data at all. Any doctor may say that his patients have a particular success rate, but supporting the claim with actual data involves considerable effort. Performing a follow-up study such as the one Dr. Berger compiles requires keeping an accurate record of patients and their findings, as well as maintaining ongoing patient contact to determine the outcomes of treatment. Without this detailed type of information, the accuracy of any claim of success rates should be questioned.
I hope this is helpful!
Julia Smith, RN
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Posted by Sarah Meacham, RN (Member # 9766) on November 27, 2007 03:16 PM:
Hi Carrie,
We keep very detailed data and statistics on each of our patients (age, tube length, medical history, tube of tubal ligation, pregnancy history, etc.). This is obtained by daily contact with our patients to ensure we have accurate information regarding their surgery and their outcome. To the best of my knowledge, Dr. Berger is the only doctor with published data regarding outcomes following reversal surgery.
Please contact me (SarahM@tubal-reversal.net) with any other questions you may have and we look forward to having you as a future patient!
Sarah
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Posted by Jennifer Okun, R.N. (Member # 1806) on November 27, 2007 03:17 PM:
Hi Carrie,
What Julia answered is exactly right! Dr. Berger has been performing the reversal surgery for over 30 years, has performed over 6,000 reversals and has the most tubal reversal babies born world-wide. So, obviously Dr. Berger's technique is the best and he is doing it the best way possible.
I have worked for Dr. Berger for nearly 10 years and I can assure you - he is an amazing surgeon!
You will have the best outcome possible if you decide to undergo reversal surgery at our facility with Dr. Berger.
You may email me anytime with questions: Jennifer O@tubal-reversal.net
Best wishes!
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Posted by Jennifer Okun, R.N. (Member # 1806) on November 27, 2007 03:20 PM:
I should also add that Dr. Berger is the only physician in the country with a practice that is specifically limited to tubal reversal surgery. That is the only procedure we perform here with Dr. Berger performing four reversals each day, five days a week. We have a high staff/patient ratio with one or two nurses devoted specifically to your care while you are here. All of our nurses have advanced certification in cardiac life support (ACLS) and our anesthesiologists are MD's with board certification in anesthesia. The anesthesiologists are employees here and not anesthesia staff from another hospital or anesthesia service. So everyone here has expertise in caring for and performing reversal surgery. While you are here, you will only be with other women and couples who are here specifically for the same purpose.
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Posted by Rhonda Brown, RN (Member # 9485) on November 27, 2007 03:36 PM:
Dear Carrie,What a good question. We get asked this question quite a bit. The best tool that any patient can have is information. I do not know of any other physician that puts out the information that Dr. Berger provides. We encourage patients to check his credentials and to ask as many questions as they need to. We provide 24/7 coverage seven days a week not only to our patients that have had surgery, but to patients that are thinking of having tubal reversal surgery.
As you browse the message board and read all the posts you will see that experience is a factor with tubal reversal surgery We have had many patients come to Dr. Berger after they had been told that tubal reversal could not be done in their case and then Dr. Berger was able to successfully repair the tubes as he is able to do in 98% of the cases.
I do not think that you will find a more caring physician who is truely devoted to the procedure that he performs as well as patient care. We as staff members feel very fortunate to be a part of this experience and would love to meet you in the near future. Please contact us if you have any questions.
Rhonda

Tubal Reversal Procedure Comfort

Making Tubal Reversal Comfortable

by Gary S. Berger, MD
Reproductive Surgeon-Director
Chapel Hill Tubal Reversal Center

Using The Best Surgical And Anesthetic Techniques

Tradionally, tubal reversal surgery microsurgery has been a major in-hospital operation with several days of hospital stay and surgical techniques that cause postoperative pain and disability. They don't think about how to minimize postoperative pain while performing a surgical procedure. Patients, of course, would prefer that surgeons avoid techniques that cause pain after they awake.

Postoperative pain following abdominal surgery is due mostly to trauma to the muscles and connective tissues in the abdominal wall when using traditional surgical techniques. Abdominal retractors (metal instruments that pull back on the skin, connective tissues, and muscles to provide exposure of the pelvic organs), cause bruising and reduced blood flow to tissues during the time they are being held apart by the retractors. In my experience - having performed over 6000 outpatient tubal reversals - the operation is best performed using no retractors at all other than just the surgeon's fingers, the gentlest of all surgical instruments.

Surgical packs (large gauze pads) traditionally are placed into the abdomen to push the intestines away from the pelvic organs. These irritate the intestines and are unnecessary in most cases.

Another technique that prevents postoperative pain is injecting a local anesthetic, even though the patient is asleep, in the areas where surgery is performed . This effective technique is called "pre-emptive analgesia".

These are some of the methods that I use that make tubal reversal comfortable as outpatient surgery. These techniques allow patients to awake in comfort and avoid the need for repeated injections of narcotic pain medications. Making surgery comfortable improves patient outcomes, avoids the need for routine postoperative hospital care, and results in low cost tubal reversal.

tubal reversal procedure insurance

Some insurance companies provide coverage for tubal reversal procedures.
The diagnosis code (ICD-9) for bilateral tubal occlusion is 628.2.
The procedure code (CPT) for tubal anastomosis is 58750.

Some states are now passing laws that have mandatory infertility insurance coverage – New York, for example is one of several such states. Under the mandate insurers provide fertility insurance as part of a standard plan, or as an option to purchase for a reasonable price.

Lobby your governor and insurance company to offer infertility coverage. If your employer chooses your insurance ask that they seek out a policy that will cover your tubal reversal procedure.

Pregnancy Testimonials

Baby and Pregnancy Testimonials After Tubal Reversal Procedures from Dr. Berger's Patients

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"We have a perfect baby boy. I want to thank every one at Chapel Hill Tubal Reversal Center, especially Dr. Berger, for making this journey possible for us." Mike and Kelley J.

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"Our tubal reversal baby keeps us busy. She is such a joy and a blessing to our whole family." Jennifer and Randy A.

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"I was so excited to find out that I was pregnant 20 months after my tubal reversal procedure." Jenn B.

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"Thank you Dr. Berger for my two TR angels." Donald and Jessie M.

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"We would like everyone to meet our second Berger Baby, Elijah Samuel. Thanks to Dr. Berger I have 2 beautiful baby boys whom I'm in love with." Ann and Michael O.

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"My husband and I just had our second TR baby boy. I had a C-section and my doctor said Dr. Berger does incredible work." Samantha B.

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"I want to thank Dr. Berger for blessing me with my new little miracle baby, born 11 months after my tubal reversal operation." Kim and Michael P.

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"When my friend, Tiffani, (who is expecting her 4th TR baby in January), told us about Chapel Hill Tubal Reversal Center, my husband and I didn’t hesitate to schedule our appointment. It was well worth the 2 ½ year wait for this beautiful Berger Baby!!!" Aaron and Barby H.

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"Thank you Dr. Berger for the work you do. It really is changing the world one little life at a time." Scott and Rachel P-W.

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"I had my tubal reversal surgery by Dr. Berger in September, 2002. I have had 2 sons after my tubal reveral so far and have just found out I am expecting another baby in April." Misty R.

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"Our Berger baby girl arrived just 10 short months after having the reversal procedure." Geni W.

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"I want to announce the arrival of our new baby girl. We are so happy we traveled to Chapel Hill Tubal Reversal Center have the reversal done. I had the tubal reversal procedure performed September 21, 2006 and we found out we were pregnant the day after Thanksgiving." Elizabeth S.

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"Kate just turned one. Turns out we got her an extra special present! Positive HPT today...we are THRILLED." Steph C.

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"It will never be lost on me what miracles these little TR boys are. Thank you, Dr. Berger and staff for helping to make our dreams come true." Renee and Jack L.

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"We are so grateful to Chapel Hill Tubal Reversal Center for the great work you do to allow families like ours to follow their hearts and bring a new life into their homes." Jennifer McN.

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"My son Dylan is a Dr. Berger miracle. I had my tubal reversal surgery in January of 2006 and Dylan was born on January 22nd, 2007." Maria M.

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"My tubal reversal baby boy is here thanks to the wonderful Dr. Berger and staff at Chapel Hill Tubal Reversal Center." Andrea P.

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"I got pregnant 2 months after my tubal reversal. Thank you Dr. Berger - I had a great pregnancy, full term, and fast delivery." Phoebe R.

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"Our 3 year old tubal reversal daughter, Hally, has changed our lives and I still appreciate everything Dr. Berger did to bring so much joy into our lives." Peggy L.

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"I had my baby 4 days after my Tubal Reversal Anniversary. Thank you, Dr. Berger - without you we wouldn't have our little miracle! " Dawn T.