Dr. Shaykh can perform tubal reversal surgery using either method. However, mini- laparotomy is more cost efficient. Mini- laparotomy also allows for more precise “stitching” and visual examination of the Fallopian tubes and patients recover quickly and can return home the same day after either procedure.
Laparoscopy is performed using a small “telescope like” device and microsurgical operating instruments. Three or more small holes are made in the abdomen usually at the belly button and pubic hair line. The primary advantage of laparoscopic surgery is less discomfort. The disadvantage is that the surgeon’s view of the internal organs can be restricted and precise re-connection of the tubes is more difficult. Laparoscopy is slightly more expensive than mini- laparotomy.
Mini laparotomy involves making a small 3-4” incision under the pubic hair line. Since this is an “open procedure”, the surgeon has an unrestricted view of all the reproductive organs. The larger operating space often allows more precise stitching and careful examination of the Fallopian tubes. Patients experience minor discomfort from the surgical incision and can usually return home the day of the procedure.
Each couple must be carefully evaluated in the process of deciding if tubal reversal surgery will be effective. Dr. Shaykh will only recommend tubal reversal surgery when there is a good chance of conception. One major determinant is ovarian reserve, or the “number” of quality eggs remaining; often assessed using day 3 FSH and AMH levels and other tests. If a woman has low ovarian reserve, there may not be sufficient reproductive time left to attempt multiple intercourse cycles after tubal reversal and success rates are low in these patients. Many of these women benefit from IVF which has a higher per cycle success rate, depending upon many patient specific patient factors including egg quality. Women with poor egg quality should consider our donor egg IVF program. See choosing a tubal reversal center.
Success rates are highly dependent upon many couple specific factors. In general, normally fertile women who have had a tubal reversal have a conception rate of approximately 20-25% per month which approaches the monthly conception rate for women with normal tubes. Female age can be a major success rate determining factor. A woman in her twenties or early thirties, with good quality eggs, can attempt numerous cycle of intercourse. With a 25%/month conception rate, pregnancy should be achieved in about six months to a year.
Success rates for IVF can approach 45-50% per cycle. In many cases, up to three cycles of IVF will be required to achieve pregnancy. These treatments can cost over $20,000 at many programs compared to Dr. Shaykh’s discounted rate per cycle.
The degree of male infertility has to be evaluated by a qualified reproductive laboratory. If moderate to severe male infertility is present, IVF using intracytoplasmic sperm injection (ICSI) is the recommended treatment. If mild male factor is present, conception is possible but the success rates per cycle are lower.
Dr. Shaykh has had good success performing tubal reversal surgeries where either the Essure or Adiana method was used. Each patient must be individually evaluated to determine the extent of damage to the tubes. See the page on tubal ligation methods.
Typically, tubal reversal at other practices can cost over $7,000. Dr. Shaykh is committed to making infertility treatments affordable and is offering a discounted cost of $5,500 to reverse tied tubes. The only additional charge is a $300 consultation fee.
The risk of tubal pregnancy after tubal reversal surgery is low, usually 2-3%.
The first step is to confirm that the tubes are still open using the hysterosalpingogram (HSG) examination. If the tubes are open, an infertility evaluation will be performed, including the male, to learn if other fertility issues are involved. These tests include measurement of day 3 FSH levels to assure that the ovaries can release quality eggs. If egg quality is diminished, or male infertility is present, IVF, IVF/ICSI, or donor egg IVF may be the best treatment choice.
The Assisted Fertility Program was the first infertility program in northern and central Florida and southwest Georgia. Dr. Shaykh is a highly skilled board certified reproductive endocrinologist, infertility surgeon who has performed hundreds of successful tubal reversal surgeries since 1985. If experience counts, Dr Shaykh is considered one of the most experienced surgeons in the field of infertility. Tubal reversal surgery is not always possible so it is extremely important that the tubal reversal center chosen have a successful IVF program such as the Assisted Fertility Program.