Conception After Tubal or Vasectomy - Phoenix

Conception After Tubal Ligation or Vasectomy – Phoenix Fertility Clinic

When they choose a tubal ligation or vasectomy, people believe that they won’t want any more children. Many people remain happy about this decision for the rest of their lives. But for some, life changes, and they want to be able to conceive again. They may enter a new relationship and want to have children with their new partner, or they may simply change their minds about having another baby. We see many patients in this situation at our Phoenix-area fertility clinic serving communities throughout Arizona, including Mesa and Tucson.

If this is your situation right now, you’re probably wondering what your options are. Should you try to have your tubal ligation or vasectomy reversed? Or do you have other options for conceiving another child?

While reversal of your procedure may be possible, in vitro fertilization (IVF) is a better option for most people. Let’s look at each procedure in detail.

Tubal Ligation Reversal vs. IVF

A tubal reversal is more difficult than the initial tubal ligation. In some cases, the fallopian tubes can be reopened, though not always. The success of the surgery depends on several factors, including the woman’s age, the type of tubal ligation she had, how long her remaining fallopian tubes are, whether she’s had other surgeries on the abdomen or pelvis, and her overall health. Even if the tubal reversal is successful, this is not a guarantee of pregnancy; pregnancy rates range from 5 to 20% per menstrual cycle, with only 40 to 85% of women achieving pregnancy.

A tubal reversal is a major abdominal surgery, in which the abdomen must be surgically opened. It carries all of the risks of surgery, such as bleeding and infection. Additionally, the risk of an ectopic pregnancy (an embryo that implants in the fallopian tube rather than the uterus, which prevents it from developing successfully and creates a life-threatening situation for the mother) is increased in a woman who has a tubal reversal. A tubal reversal costs around $16,000.

Because of the risks associated with surgery and the risk of ectopic pregnancy, tubal reversal is rarely done anymore. Instead, most women use in vitro fertilization (IVF) to have a child after a tubal ligation. This simply bypasses the fallopian tube, with the egg being fertilized in the laboratory. Eggs are removed from the ovary, combined with sperm in the laboratory, and the resulting embryos are transferred directly into the uterus. For more information about what the IVF procedure is like, see our IVF page, or check out our IVF ebook to learn about the details.

Advances in technology have led to much higher success rates for IVF than in the past. IVF pregnancy rates are up to 50% per embryo transferred (depending on the age of the woman). For many women, IVF is more likely than tubal reversal to lead to pregnancy. It also costs significantly less than tubal reversal. While there can be side effects from the medications used during IVF, these are usually less serious than the risks of surgery. For these reasons, at our Phoenix fertility clinic, we recommend IVF over tubal reversal for our patients.

Vasectomy Reversal vs. IVF

In many cases, a vasectomy can be reversed using microsurgical techniques. The vas deferens, the tube that carries sperm from the testicle and was cut during the vasectomy, can often be reconnected. This procedure is more complex than a vasectomy; it takes about two to four hours and is usually performed under general anesthesia.

However, even if the vasectomy reversal is successful at establishing an open vas deferens, pregnancy does not always result. This is because, after a vasectomy, a man’s body often forms antibodies against his own sperm. This means that his immune system destroys the sperm, which may mean that he doesn’t produce enough healthy sperm to successfully fertilize an egg.

The likelihood of the man’s partner becoming pregnant after his vasectomy reversal depends strongly on how long it’s been since the vasectomy was originally performed. If it’s been fewer than ten years, the success rates are as high as 50%; however, if it’s been ten years or longer since the vasectomy, only 30% of men are able to impregnate their partners after reversal. This means that more than 2 out of 3 men who have a successful vasectomy reversal still don’t conceive a child. Vasectomy reversal is not performed at Reproductive Health Center of Tucson, but if you decide that you want to have this procedure, we can refer you to a qualified urologist who can do the surgery.

An alternative to vasectomy reversal is IVF. Sperm can be retrieved directly from the testicle, via procedures known as TESA or PESA, bypassing the vas deferens. When the sperm are combined with the partner’s eggs in the laboratory, a procedure known as intracytoplasmic sperm injection (ICSI) can be used, in which the sperm is injected directly into the egg cell to ensure fertilization. This is useful if the numbers of sperm are low or the sperm have abnormal shapes or low motility.