Tubal ligation in Tucson is one of the most sought after birth control procedures. In this method, the surgeon blocks the patient’s fallopian tubes, which carry eggs from the ovaries to the uterus. Dr. Scot Hutchison of Reproductive Health Center, Tucson, speaks about the options for getting pregnant after tubal ligation procedure. Sometimes, couples who opt for tubal sterilization may want to have another child. In that scenario, as Dr. Hutchison states, there are two alternatives. The couple can either have a tubal reversal surgery or can opt for IVF. Both the methods have their pros and cons. Tune in to know more about tubal pregnancies and IVF.

Dr. Scot Hutchison

We have many patients who have had prior fertility before, who had tubal ligations or tubal sterilizations and that’s a procedure where the fallopian tubes are ligated or obstructed, usually in about the mid part of the fallopian tube so that the eggs can’t be picked up. The woman still ovulates, but sperm can’t get through and fertilize those eggs so that pregnancy is prevented. Many couples after they have had children before then will regret that decision and then want to go ahead and have more children later. And the big question is then which way do you go as far as trying to achieve that. You can go the traditional method, which is surgical reapproximation of those fallopian tubes. And that’s done with microsurgical technique and then fallopian tubes can be re-enhanced, rejoined together to allow then sperm to get through the fallopian tube obstruction site to fertilize eggs and then hopefully the egg get back through that new joint in the fallopian tube to get back to the uterus. The other method is to just bypass the fallopian tubes entirely and use In Vitro Fertilization. Since In Vitro Fertilization rates have risen over the last decade or so, there’s been a big shift in these patients’ choices. Traditionally they use to choose tubal surgery. About 9 out of 10 patients now choose to do In Vitro Fertilization and I would say that the primary reason is that with In Vitro Fertilization, we don’t have to reverse the tubal ligation. So that after that couple conceives they don’t have to have another tubal ligation again. Another reason that patients will choose In Vitro over tubal surgery is that it has a higher per month chance of success than the tubal reversal, especially in patients who are now into their later thirties and beyond. The other problem with tubal reversal is that now that you’ve rejoined the tubes, even if the tubes are back together they may not work as a dedicated unit. We know that the fallopian tube behaves more like the small intestine than it does really a just a tube. The fallopian tube needs to have good surface lining on the inner side of the tube to provide nutrient material for sperm and eggs and then in embryos. It also need, the tube needs to be able to peristalse or contract in sequence to be able to help bring back that embryo into the uterus. And so many patients will have tubal pregnancies after tubal reversal surgery. So, that’s a definite drawback to tubal ligation reversal. But nonetheless, some people will appreciate the more natural method of conception because with tubal reversal surgery, if the tube stays open and the semen analysis is fine, the male partner is fertile then intercourse is all that that couple needs to do to have a reasonable chance of pregnancy. With In Vitro Fertilization, obviously, when we are taking out the eggs and fertilizing them in the laboratory then that adds a, you know, a little more unnatural kind of approach to that particular problem. So, it really is upto the individual couple as to what they would like to do. Overall though I think that the In Vitro Fertilization is probably a better fit for most of these patients because they don’t want to have to have a tubal ligation again or vasectomy after they have as many children they want to have. And also, the risks of In Vitro are probably a little lower than they are for tubal surgery.

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