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

Patient Population and Characteristics

The study population consisted of 5,046 women who underwent tubal reversal surgery from July 2000 through June 2008 at Chapel Hill Tubal Reversal Center.

Women’s Ages

The women in the study ranged in age from 20 to 51 (Figure 1). The mean average was 34 years of age.  Approximately three-fourths of the women were in their 30s.

Figure 1. Age Distribution of Study Population

Years of Age

Tubal Ligation Methods

The type of tubal ligation that was performed is an important factor affecting the outcome of  tubal reversal surgery. The most common method involved tying and cutting out a segment of the tube (ligation/resection). The second most common method was tubal coagulation (burning the tubes) followed in frequency by mechanical occlusion with tubal clips or rings. Other procedures, including fimbriectomy (removing the end of the fallopian tube) were the least common. In cases where the patient’s operative report of the tubal ligation was not available, the method was classified as unknown.

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

Pregnancy Rates At Chapel Hill Tubal Reversal Center

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.

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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

References:

http://www.medicalnewstoday.com/articles/108058.php
http://www.tubal-reversal.net/doctor-monteith.htm

Tubal Reversal Surgery – How to choose the best doctor

When women begin researching tubal reversal surgery, there are several questions that are frequently asked. These questions are typically based on the differences that become apparent when they compare various facilities and doctors.

“How do I choose a doctor?” Considering the number of choices, it is one of the most important questions to consider before a woman moves forward with planning her tubal reversal procedure. Training, experience, availability, and patient support can vary greatly between doctors and facilities.

Most women who research the option of tubal reversal surgery after a tubal ligation are interested in how many reversal procedures the doctor has performed. Many reproductive surgeons have performed a tubal reversal procedure, but few perform the procedure routinely and even fewer limit their practice to this specialty. In the case of tubal reversal surgery, experience is an important factor in predicting the outcome of the procedure. Chapel Hill Tubal Reversal Center is the only medical facility specifically for tubal ligation reversal surgery. Dr. Gary Berger performs 4 reversals a day and has performed more than 7000 reversal procedures in his career.

Another question women frequently ask is whether the doctor uses the dye technique or a stent to ensure the tubes are open following surgery. The use of the dye technique is not the most accurate indicator regarding whether the tubes are open following tubal repair to allow conception. The stent technique is the better approach in our opinion to avoid any doubt. The stent is sterile and does not pass through the cervix. The stent not damage the tubes, and it ensures that they are open so a dye test is not necessary. With the stent technique used by Dr. Berger, there is no question regarding tubal patency following surgery, which puts the woman in a much better position for achieving pregnancy following surgery.

A common question during the process of researching tubal reversal facilities is whether the doctor uses permanent or absorbable suture to repair the fallopian tubes and whether he or she reconnects each of the tubal layers. While some doctors may suture all of the tubal layers, Dr. Berger uses permanent suture and sews the muscular and outer serosal layers together. He does not place suture in the inner endothelial layer as this may increase the risk of scar formation within the tubal lumen. In Dr. Berger’s opinion, this is the best approach. Comparing doctors’ data regarding pregnancy outcomes is the best way to assess their techniques since high pregnancy rates are a clear indication that the techniques are successful.

Ultimately, the most frequently asked – and most important – question regarding tubal reversal surgery is, “What are the doctor’s success rates”. Since pregnancy and its outcome are the primary concerns of most women who choose the reversal procedure, the answer to this question should be based on accurate statistical data. 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. At Chapel Hill Tubal Reversal Center, Dr. Berger and his staff do everything possible to obtain and report this information on an ongoing basis. This allows them to remain informed about the number of pregnancies achieved and what their outcomes were after tubal reversal and to answer questions and guide patients who are waiting to become pregnant.

The decision to undergo surgery to restore fertility after a previous sterilization is a serious one for any couple. Where to go for surgery and with whom care will be entrusted is an important part of that decision. Potential patients should expect that they have been given detailed, accurate information regarding costs and recovery times, as well as careful analysis and reporting of accurate statistics regarding pregnancy and birth rates. This is referred to as “evidence based medicine” and is consistent with the mission of Chapel Hill Tubal Reversal Center. It is one of the many reasons why the facility has become known as the best place to have tubal reversal surgery.