During 2006 in the United States, 99,199 IVF cycles using fresh non-donor eggs or embryos were begun. Of these, 34,719 (35%) resulted in pregnancy and 28,404 (29%) resulted in live birth deliveries. Pregnancy rates after tubal reversal and after IVF were compared based on the age categories reported in the National Summary and Fertility Clinic Reports (Figure 3). The pregnancy rate after tubal reversal was higher than after IVF within every age group.
Figure 3. Pregnancy Rates After Tubal Reversal vs IVF
Tubal Reversal
IVF
Age
Similarly, birth rates were higher after tubal reversal at Chapel Hill Tubal Reversal Center than after IVF for women of all ages and the differences increased with increasing maternal age (Figure 4).
Figure 4. Birth Rates After Tubal Reversal vs IVF
Tubal Reversal
IVF
Age
Comparing Tubal Reversal and IVF
Tubal reversal surgery differs from IVF in significant ways. The chances of getting pregnant after tubal reversal continue each month following the surgery. The pregnancy rate after tubal reversal, therefore, continues to increase over time and more than one pregnancy and birth can result from a sterilization reversal procedure. With treatment by IVF, the outcome is immediate. If pregnancy does not occur, then a couple must decide whether or not to go through the treatment process again. Since the chances of getting pregnant after tubal reversal are cumulative over time, this procedure results in higher pregnancy and birth rates than after an IVF cycle.
Tubal Reversal Pregnancy Study Report 2009 Table Of Contents:
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.
Contact Information: Lisa Hourmouzis, RN 919.968.4656 office 252.339.2322 mobile LisaH@tubal-reversal.net
New tubal reversal specialist joins Chapel Hill center FOR IMMEDIATE RELEASE: July 21, 2008
CHAPEL HILL, N.C. – Dr. Gary S. Berger, medical director and world-renowned tubal reversal surgeon, welcomes Dr. Charles W. Monteith to the Chapel Hill Tubal Reversal Center surgical team.
Dr. Monteith is the first tubal reversal surgeon to join the practice since the initial tubal reversal microsurgery performed by Dr. Berger in 1982.
Monteith began his fellowship training with the center in January 2008, and has assisted in more than 100 reversal procedures under the guidance of Dr. Berger.
According to Dr. Monteith, his plan is to keep tubal reversal surgery a viable option for women wanting to have children after tubal ligation surgery.
“My interest in becoming a tubal reversal surgeon began when I realized that tubal reversal surgery was gradually becoming less available to patients because of limited training opportunities for younger physicians,” said Monteith.
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.
Chapel Hill Tubal Reversal Center is the only facility in the United States dedicated exclusively to tubal reversal surgery. Dr. Gary Berger has successfully performed over 7,000 tubal reversals using the one-hour outpatient microsurgical technique he developed and refined. His technique has been featured on The Learning Channel and Discovery Health.
Dr. Charles Monteith to Join Staff at Tubal Reversal Center
(Chapel Hill, NC) – Dr. Gary S. Berger, medical director of Chapel Hill Tubal Reversal Center in Chapel Hill, North Carolina, announced today that Dr. Charles Monteith will join the staff at Chapel Hill Tubal Reversal Center effective July 21, 2008.
Dr. Berger has been performing microsurgical tubal anastomosis and tubal implantation at Chapel Hill Tubal Reversal Center since 1982. This is the first time that Dr. Berger has offered fellowship training in tubal reversal surgery.
Under the guidance of Dr. Berger, Dr. Monteith has been undergoing certification in tubal ligation reversal surgery since January 2008, and has assisted in more than 100 reversal procedures.
“My interest in becoming a tubal reversal surgeon began when I realized that tubal reversal surgery was gradually becoming less available to patients because of limited training opportunities for younger physicians,” said Monteith.
His desire to keep tubal reversal surgery as a viable option for women led him to leave a successful practice in obstetrics and gynecology to start a career in tubal ligation reversal.
Dr. Monteith attended college at Xavier University of Louisiana where he graduated summa cum laude. He attended medical school at the University of California at San Francisco where he received a Howard Hughes Medical Research Fellowship and conducted research in molecular genetics. After completing his residency in obstetrics and gynecology at the University of North Carolina at Chapel Hill, Dr. Monteith accepted a clinical assistant professor position with the department of obstetrics and gynecology at the University of North Carolina in 2001.
He worked as an 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. Dr. Monteith spent a significant amount of time training both medical students and residents.
Dr. Monteith is currently operating with Dr. Berger and will be certified as a tubal reversal specialist once his fellowship is completed. Dr. Monteith is now scheduling patients for tubal reversal surgery beginning July 21 at a reduced introductory fee. During July and August, Dr. Berger will assist Dr. Monteith with his tubal reversal procedures. Dr. Berger says that by the time Dr. Monteith is operating on his own, he will be well qualified as an expert and will have participated in more tubal reversal procedures than most other specialists may see in a lifetime of practice.
Dr. Monteith said, “I look forward to a successful career in tubal reversal surgery. It is with special gratitude that I thank Dr. Berger and the staff at the Chapel Hill Tubal Reversal Center for accepting me with open arms and training me in both the science and art of tubal ligation reversal.”
Chapel Hill Tubal Reversal Center is the only facility in the United States that is limited specifically to the practice of tubal reversal surgery. Additional information regarding tubal reversal surgery at Chapel Hill Tubal Reversal Center, including profiles for Dr. Berger and Dr. Monteith, can be found on the Web site at www.tubal-reversal.net.
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Julia Smith, RN Nurse Administrator Chapel Hill Tubal Reversal Center JuliaS@tubal-reversal.net Phone: (919) 656-8204
Reproductive surgeon and tubal reversal expert leads the way in tubal reversal field.
CHAPEL HILL, N.C. – At Chapel Hill Tubal Reversal Center, Dr. Gary Berger understands that hope is not just a word to the hundreds of women who come to his center each year. Hope is what they find in him.
When Amanda Nelson first decided to have a tubal ligation in 1997, she never imagined she would find herself in Chapel Hill, North Carolina, 4,000 miles away from her home in Cumbria, England about to undergo a tubal ligation reversal.
“I had been married for a number of years when my marriage broke down,” said Amanda. “I had two boys to look after, so I waited a year and then went ahead with my tubal ligation. At the time, the thought of having children with a different father didn’t appeal to me.”
Like Amanda, many women who come to Chapel Hill Tubal Reversal Center have faced life changes such as divorce, loss of a child or remarriage.
“Years went by, and then I met David. He had no children and happened to mention he would like one of his own some day,” said Amanda. “It took me awhile to think about it, but decided to look up having the operation.”
They began searching online for tubal reversal specialists. Their search brought them to the Chapel Hill Tubal Reversal Center Web site and Dr. Gary Berger.
Over the past 26 years, Dr. Gary Berger has performed over 7,000 tubal reversals as a one-hour, outpatient operation. Recognized as a leader in the field, Dr. Berger has been featured on The Learning Channel and Discovery Health.
Patients come to Chapel Hill from across the United States and abroad to have him perform the procedure. Using microsurgical techniques he developed and refined, Dr. Berger can successfully repair the fallopian tubes in 98 percent of the women who want their tubes untied.
Most women are typically discharged from the facility within two hours after surgery. And most resume normal activities within five to 10 days. This outcome is far better for patients than the standard approach to tubal ligation reversal that requires hospitalization for several days, longer recovery times and unnecessary hospital costs.
To learn more about Dr. Gary Berger and his team at Chapel Hill Tubal Reversal Center, visit www.tubal-reversal.net.
Lisa D. Hourmouzis, RN Chapel Hill Tubal Reversal Center Nurse Tel 919.968.4656 LisaH@tubal-reversal.net
Post tubal ligation syndrome (PTLS) is a term used to describe a variety of symptoms that may occur after a tubal ligation. Symptoms that women frequently report include increased menstrual bleeding and cramps, hot flushes, night sweats, irritability, and mood swings. These are thought to be due to changes in hormone levels. One theory about what may cause these symptoms after a tubal ligation has to do with interruption of blood circulation between the ovaries and uterus that affects the production of ovarian hormones.
Doctors differ in their opinions about whether post tubal symptoms constitutes a true syndrome. It has been a subject of controversy n the medical literature for decades. Studies have reported conflicting conclusions about whether these symptoms are more common among women who have had a tubal sterilization than among women who have not had a sterilization procedure.
Women who describe their symptoms are convinced that PTLS is real and they argue that doctors should recognize this as a true medical syndrome. Many of these women have been told by doctors that the symptoms they have developed after their tubal ligation could not be related to the surgery and often report that they feel they aren’t taken seriously. Some doctors recommend treatment with birth control pills, antidepressants, anti-anxiety medications, referral to a psychologist, or even hysterectomy.
During the past several years, increasing numbers of patients have requested tubal reversal surgery in hopes of finding relief from PTLS symptoms. A recent study of 91 women reporting PTLS used a standardized questionnaire prior to tubal reversal and at 6 month intervals following tubal ligation reversal to gather statistical data regarding the possible effects of tubal reversal on PTLS symptoms. The study found that 90% of reported improvement in their PTLS symptoms, 8% reported no change, and 2% reported an increase in symptoms after tubal ligation reversal.
Members of the Tubal Reversal Message Board often discuss PTLS and how tubal reversal surgery has helped alleviate symptoms. These women uniformly disagree with the concept that symptoms that they have experienced since their tubal ligation are “just in their heads”. They are certain that their symptoms are not imaginary and are grateful when their symptoms disappear after tubal reversal surgery. The Message Board members offer encouragement and support to women who have similar symptoms and feelings and it helps them to realize that they are not alone. Following are some examples of posts on the subject of PTLS on the message board.
“I want to say thank you… my PTLS is practically gone and gets better ever month. I did not realize how bad I was truly feeling until I felt better and I thank you. I thank you for ‘putting me back together’ and for giving me the opportunity to have another child.”
“My name is Rhonda I had the reversal done because of the Post Tubal Syndrome caused by my tubal ligation. Although I realize that some people think that this Syndrome doesn’t exist, I can tell you that is does. I am so grateful that I found you and your staff. The results I have had since the reversal surgery have been tremendous.”
Conclusion: Counseling before having a tubal ligation rarely includes the possibility of menstrual and other symptoms encompassed by the term “post tubal ligation syndrome”. When women develop problems following female sterilization, they are frequently informed that their symptoms have nothing to do with the tubal ligation procedure. The purpose of this article is to promote awareness of PTLS and the possibility that tubal reparative surgery may remedy the problems.
Gary S. Berger, M.D. Reproductive Surgeon Medical Director
Chapel Hill Tubal Reversal Center 109 Conner Drive Suite 2200 Chapel Hill, North Carolina 27514
109 Conner Drive Suite 2200, Chapel Hill, NC27514(919) 968-4656
Outpatient Tubal Reversal
http://www.tubal-reversal.net/patient-satisfaction-messages/Messages from tubal reversal patients of Dr. Berger and Dr. Monteith about the care they received at Chapel Hill Tubal Reversal Center
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109 Conner Drive Suite 2200, Chapel Hill, NC 27514 Tel: (919) 968-4656 Fax: (919) 869-1976
Tubal Reversal 
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