Considerations prior to tubal reversal
Surgical expertise and experience
There is no doubt that the most important issue that you should take into consideration is the skill and experience of the surgeon who performs your tubal ligation reversal. I am a full time fertility specialist who concentrates on reproductive microsurgery and as such I am continually performing tubal ligation reversal procedures. In addition, I have a dedicated surgical team who exclusively assist me in performing tubal reversals. The same staff doing the same procedures, all of the time, means maximum expertise and experience available to you.
Reasons for tubal reversal
A new relationship is by far the most common reason for wishing to have a tubal reversal - but it is not the only one. A simple change of heart or family tragedies while uncommon do occur. Tubal reversal is even more successful when performed on couples in the same relationship with prior children. Occasionally tubal reversal is performed for religious belief or change in menstrual pattern.
The single most important factor influencing the prospect of successful pregnancy following tubal reversal has nothing to do with the surgery itself. It is the your age. The prospect of successful pregnancy dramatically declines with female age. For healthy previously fertile women over the age of 40 years the total probability of successful pregnancy is not greater than 40%. Indeed miscarriage rates at age 40 are 40% per pregnancy. Obviously the older you are the more likelihood that you may have some additional medical problem which may influence that safety of surgery or the chance of complications. In addition many people will think about the difference in age between parent and child as you get older.
Time since your tubal ligation
There is little doubt that the length of time since your tubal ligation is an important factor. Its influence on the ultimate success of your tubal reversal is however due to increasing age rather than any long term effect of tubal ligation. While trained Reproductive Microsurgeons such as myself achieve patency rates of the Fallopian Tube in excess of 98% there is however an obvious decline in pregnancy rates when female age exceeds 40 years This effect becomes quite marked beyond 45 years.
Other gynaecological problems
A range of common gynaecological problems such as fibroids, endometriosis, pelvic adhesions and ovarian cysts can all interfere with both the performance of tubal reversal and the results from the procedure. Many of t he disorders can be treated at the time of your tubal reversal.
It is important to be aware of your general state of health prior to any surgical procedure. There are a variety of conditions which may effect the outcome of your operation. In particular cardiovascular, respiratory and neurological disease may also be of major significance for your anaesthetic. Smoking has been shown to reduce fertility by affecting egg function as a result of toxins. Please ensure that I am made fully aware of your past medical history at the time of your pre-operative consultation.
Your partners age and health
A normal sperm count is of considerable importance in achieving pregnancy. It is therefore wise to have your partner checked prior to your tubal reversal. General medical conditions which affect his health are of importance. Some medications that men take may interfere with sperm production. Smoking and heavy alcohol consumption definitely reduce male fertility.