Monday, March 26, 2012

Ask Us Anything: Can Women Over 40 Have a Tubal Reversal?

"Is it possible for women over the age of 40 to have tubal reversal? What is the success rate?"

Dr. Ali Ghomi Responds:

Tubal ligation reversal or tubal reanastomosis can be performed at any age.

The procedure reverses tubal ligation, or having one’s tubes tied, so that pregnancy is possible.

The success rate mainly depends on a number of factors, including ovarian function or reserve (the number of eggs remaining), the technique by which the tubes were originally ligated and the patient's age.

The success of the tubal reversal procedure is inversely proportional to the length of the tube removed at the time of ligation. During tubal ligation, the fallopian tubes are burned shut or clamped off with a clip or ring to prevent eggs from reaching the uterus.

Tubal ligation via electrocautery or the burning method seems to have a less favorable outcome when compared to the rings (Falope Rings) application. According to one large study, pregnancy rates after tubal ligation reversal among women aged 15 to 30 years, 30 to 33 years, and 34 to 49 years were 73, 64, and 46 percent, respectively. Most pregnancies occurred within two years after reversal.

In summary, the success of tubal ligation reversal is dependent upon a number of variables, including the patient's age, the length of the tube available for reversal, and the method by which the tubes were originally ligated.

Minimally invasive alternatives to conventional open-incision tubal reversal surgery, such as laparoscopic-assisted or robotic-assisted approaches, may also be considered to provide faster postoperative recovery and less pain without compromising the final outcome.

— Dr. Ali Ghomi

Dr. Ghomi is the Director of Minimally Invasive Gynecologic Surgery and Chair of The Robotic Surgical Committee at Sisters of Charity Hospital. In September 2011, Dr. Ghomi performed the area’s first tubal reversal surgery using the da Vinci Robotic Surgical System.

Dr. Ghomi sees patients at the M. Steven Piver, M.D. Center for Women’s Health & Wellness in Buffalo.

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  1. what kind of complications did or do women have after having the procedure???

  2. Besides the commonly quoted complication of any surgery, such as bleeding and infection, the most concerning complication of tubal reversal is the development of post-op tubal pregnancy, which is less than 5%.

  3. How to know if I am a good candidate for this procedure, I have 42 years, but healthy. This will cover any medical plan?


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