Tubal Reversal Pregnancy Study 2009

Pregnancy Rates By Fallopian Tube Lengths

The fallopian tube lengths remaining after a tubal ligation procedure are important determinants of the chances of getting pregnant after tubal reversal surgery. (Normal fallopian tube length before a tubal ligation is approximately 10 cm or 4 inches.)

Tubal segment lengths are measured routinely during surgery at Chapel Hill Tubal Reversal Center. The average length of the two fallopian tubes after repair was correlated with the likelihood of pregnancy after tubal reversal (Table 6). Women with longer tubal lengths had higher pregnancy rates than women with shorter lengths following tubal reversal. Women with tubal lengths of 7.5 cm or longer had a pregnancy rate of 77%. The pregnancy rate declined as tubal length decreased, but even women with the shortest tubes (less than 2.5 cm) became pregnant (38%).  Although previously unreported in the medical literature, it became apparent during this study that a repaired fallopian tube of any length can result in pregnancy. Based on reports by women with only 1 fallopian tube, we now know that tubal lengths as short as 1 cm can result in a normal pregnancy.

Tubal Ligation Method And Tubal Length

When tubal ligation method and average tubal lengths are taken into account simultaneously, it becomes clear that the amount of fallopian tube remaining after a sterilization procedure is the more important factor predicting the chances of getting pregnant after tubal reversal surgery (Table 7). This makes sense, since the less damage that occurs to the fallopian tube during a sterilization procedure, the more remains to be able to function normally once the tube has been surgically repaired.

Tubal Reversal Pregnancy Study 2009
Table Of Contents:

• Overview
• Study Method
• Patient Population – US States
• Patient Population – Age and Tubal Ligation Procedures
• Pregnancy Rates by Age and Method
• Tubal Reversal Pregnancy Rates by Tubal Lengths (this page)
• Pregnancy Outcomes
• Tubal Reversal vs. IVF
• About Pregnancy Statistics

Pregnancy Outcomes After Tubal Reversal

Tubal Reversal Pregnancy Report 2009

Study Method

Prospective Study

This is a prospective observational study of 5,046 women who had tubal reversal surgery from July 2000 through June 2008 at Chapel Hill Tubal Reversal Center – an outpatient facility exclusively for tubal ligation reversal. This ongoing study was begun in 2000 with the development of a computerized database to record information for subsequent analysis. Patients who had tubal reversals prior to the initiation of the database are not included in this study report. The study cut off date of June 2008 was chosen to allow for at least one year of follow-up for all patients in the present analysis and report.

Information about pregnancies is collected through the Center’s ongoing patient follow-up protocol. Patients are asked to notify the Tubal Reversal Center staff when a pregnancy occurs by completing an online Pregnancy Report Form. All women reporting pregnancies are contacted by staff nurses to determine the outcome of each pregnancy. The information is entered into the center’s electronic patient database for subsequent statistical analyses.

Tubal Reversal Techniques

The tubal reversal procedures were performed using outpatient mini-laparotomy surgical and anesthetic techniques that minimize tissue injury, blood loss, anesthesia time, postoperative pain, and recovery time. Dr. Berger explains these advanced techniques in a video recording of the surgery entitled Outpatient Tubal Reversal. This video has been shown on “The Operation” television series broadcast on Discovery,The Learning Channel (TLC), and the CBS Early Show.

The tubal reversal operations for these 5,046 women included the following techniques depending on the requirements of each patient:

• tubal anastomosis
• salpingostomy
• tubouterine implantation

Tubal Reversal Pregnancy Rate

From July 2000 to June 2008, 5046 women underwent tubal ligation reversal at Chapel Hill Tubal Reversal Center. The operative techniques of microsurgical tubal anastomosis, tubouterine implantation, and salpingostomy were used as appropriate to each patient’s situation, and often these techniques were combined in a single case. Including all women’s ages, methods of tubal ligation, and operative techniques used for tubal reversal, the overall pregnancy rate was 66% based on 3317 pregnancies reported during this 8 year interval.

Subsequent pages in this report break down this overall pregnancy rate for all patients into more specific pregnancy rates based on age, type of tubal ligation, and the remaining tubal lengths available for repairing. These statistics will help women wanting to get pregnant after a tubal ligation. With this information, they can make informed decisions based on their chances of getting pregnant after tubal reversal that are specific to their age and method of tubal ligation.

Tubal Reversal Pregnancy Report 2009
Table Of Contents:

• Overview
• Study Method (this page)
• Patient Population – US States
• Patient Population – Age and Tubal Ligation Procedures
• Pregnancy Rates by Age and Method
• Pregnancy Rates by Tubal Length
• Pregnancy Outcomes
• Tubal Reversal vs. IVF
• About Pregnancy Statistics

DVD of “The Operation” Shows Dr. Berger’s Tubal Reversal Procedure Step-by-Step