QuestionQUESTION: I had a c section oct. 30 2007 and also had a tubel. All I remember that day is hearing the docs saying they burned them and would be miracle if i got pregnant. Well, I work for a non profit organization that does free preg. tests for women and young teens and had someone come in to discover she was pregnant after having tubel within the last yr. She was devistated and also to my surprise we have the same doc. I have met a wonderful man and would possibly want to get pregnant again. What are my chances? Or odds of this happening?
ANSWER: Dear Jen,
Thank you for your question. Please let me know where you are writing from.
Without knowing the exact procedure that was done, I can't tell you whether or not you are at risk of a pregnancy. In most cases of tubal ligation at c-section, the MD has the ability to cut and remove a large segment of tube and burn the remaining tube to insure sterility. There is a legal risk if pregnancy occurs so they want to make sure that does not happen.
Overall, there is a 1% chance of pregnancy after tubal ligation. With the resulting pregnancy, there is a very high risk of tubal pregnancy, which is an emergency. That patient you saw needs to see someone right away. Tubal pregnancies can lead to rupture and hemorrhage and, in some cases, are fatal.
In terms of your options to become pregnant, there are two options: surgical reversal/repair of the tubes or in vitro fertilization (IVF). Both cost about the same $13,000-15,000 total. If too much of your tubes were damaged by the burning, then a reversal is not an option. You would then only have the option of doing IVF. However, nowadays, most infertility specialists that offer IVF, prefer that method because the pregnancy rates are much much higher than the surgical reversal. The only docs that promote reversal are, generally, docs that cannot do IVF. To give you an example, the chances of pregnancy per month in the less than 30 years old age group is 10-15% per month if the procedure is successful i.e. the tubes are reattached and open. Whereas with IVF it is 50-63% per month. In the 30-35 yo group it is 5-10% per month versus 50-63% per month. In the 36-38 yo group, it is 3-5% per month versus 45-50%. You can see that IVF is much better. That is what I recommend to my patients.
Word of caution. Beware of clinics that advertise a 75-805 pregnancy rate after tubal reversal. They are generally quoting a per year rates (after 12 months of trying). They are also quoting the youngest patients. They also exclude patients whose reversals don't work (are not open after the surgery) or cannot be done at the time of surgery.
I hope that answers your questions.
Sincerely,
Edward J. Ramirez, M.D.
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
---------- FOLLOW-UP ----------
QUESTION: I have heard that IVF is very painful. Is this true?
AnswerHi Jen,
No. IVF is not painful. It is uncomfortable, however, because your ovaries swell from all of the eggs that are growing. The egg retrieval is done by passing a needle through the vagina, into the ovaries. I use conscious sedation for this so my patients are sleeping while I remove the eggs. It takes 5-10 minutes. There are programs, however, that don't use any anesthesia. I would avoid those. Putting back the embryos is like a pap smear.
Sincerely,
Edward J. Ramirez, M.D.
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
