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

Tubal Reversal Pregnancy Study Report 2009

About Tubal Reversal Pregnancy Statistics

Gary S. Berger, MD
Medical Director

What To Believe

Claims about the chances of getting pregnant after tubal reversal are often made without supporting documentation such as the number and characteristics of the patient population, study method, and length of follow-up after surgery. These are essential for understanding the basis of pregnancy rates. Statistics must be based on specified numbers of patients for any characteristic, such as age or tubal sterilization method. Most internet sites about tubal reversal do not provide any data at all. Although a doctor can say that his patients have a high success rate, supporting documentation is needed to know whether the claim is valid. The accuracy of any claim of success rates should be questioned in the absence of detailed information.

Evidence Based Medicine

The only way a doctor can truly know what the pregnancy and outcome statistics are for his or her patients is to maintain ongoing patient contact about the outcomes of treatment and record the information systematically in an analytical database. At Chapel Hill Tubal Reversal Center, nurses enter information into an electronic patient database at the patient’s registration, the surgical procedure, and all post-operative communications between patients and staff. Patients are contacted routinely by our nurses during the first year after their tubal reversal procedures.

Chapel Hill Tubal Reversal Center Database

The comprehensive follow-up database at Chapel Hill Tubal Reversal Center is unique. We know of no other doctor or medical facility with a follow-up system and database that can provide such accurate statistics about the chances of getting pregnant after tubal reversal and the outcomes of the pregnancies that occur.

Limitations And Possible Under Reporting

Although we encourage patients to inform us when they have a positive pregnancy test, not all pregnancies are ascertained. Some patients become lost to follow-up after surgery. This occurs when someone moves or changes email address and telephone numbers but does not provide their new contact information to us. In these cases, we may not find out about the long term outcomes of their tubal reversal procedures unless they complete the Pregnancy Report Form each time they conceive. We know that not all patients adhere to this protocol. From the women who do remain in contact with us over the long term, however, it is clear that new pregnancies continue to occur as time passes after surgery. The pregnancy rates reported in this study, therefore, are minimal estimates of the cumulative pregnancy rates for patients at Chapel Hill Tubal Reversal Center.

Tubal Reversal Pregnancy Report 2009
Table Of Contents:

• Overview
• Study Method
• 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 (this page)

Weekly Pregnancy Announcements From Chapel Hill Tubal Reversal Center Patients

Tubal Reversal Pregnancy Study Report 2009

Gary S. Berger, M.D.
Reproductive Surgeon

Overview

Tubal reversal is the most successful treatment for women wanting to get pregnant after having a tubal ligation. This report presents detailed pregnancy statistics from over 5000 patients at Chapel Hill Tubal Reversal Center. It is the largest study ever reported about tubal ligation reversal, pregnancies, and pregnancy outcomes.

Introduction

The desire to have a baby after a tubal ligation is common for women in second marriages, following the loss of a child, wanting to restore their bodies to be whole again, and for a variety of other reasons.

Most people are not aware that tubal ligation – usually considered a permanent method of birth control – can be reversed through low cost, one hour outpatient surgery. Even many doctors think mistakenly that treatment by in vitro fertilization (IVF) is needed for women who want another baby after having a tubal sterilization. The results from this study show that tubal reversal at Chapel Hill Tubal Reversal Center is successful for most women wanting to get pregnant after having their tubes tied.

Tubal Reversal – The Alternative to Treatment by IVF

Information is widely available about in vitro fertilization (IVF) results in the United States from the Centers for Disease Control (CDC). Tubal reversal pregnancy and birth statistics, however, are difficult to find and generally have been based on small numbers of patients under special study conditions. This report analyzes pregnancy rates and pregnancy outcomes for a very large population of women (5,046) who had tubal reversal procedures at Chapel Hill Tubal Reversal Center. This is the most detailed study of tubal reversal surgery available on the internet or in medical publications.

Tubal Reversal Pregnancy Study 2009

Table of Contents:

• Overview (this page)
• Study Method
• 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

Weekly Pregnancy Report Forum