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Michael
C. Doody MD/PhD/FACOG/REI
The Center for Reproductive Medicine
The Tubal Reversal
Professionals
The decision to take steps to have more children is one of the biggest and most
important decisions a couple can make. The following are some questions that couples
consider frequently at this stage.
 | The doctor who tied my tubes told me he would "cut, tie and
burn my tubes" and that it would be permanent and irreversible. Does this mean that
they can't be fixed? (Tubes can be fixed about 90% of the time even when patients were
told this. As physicians we are trained to make absolutely sure that tubal sterilization
is truly what the patients want to do, and sometimes this leads to some amount of
exaggeration when the operation is discussed. However, the type of tubal ligation
operation is very important. It is really desirable to get a copy of the operative note
from the hospital where the tubes were tied, because a very small number of doctors
perform a "fimbriectomy" to block the tubes, and this kind of procedure is
essentially impossible to repair. Estimates in the dictation or the pathology report of
the amount of tube damaged or the amount of tube left are completely unreliable, in
our opinion, and should almost never be used to make a decision about operability.
Call the medical records department of the hospital and ask for the forms to fill out to
get your op note. Getting these records is your right as a patient, and any charges should
be very minimal. We would be happy to review your op note to assess your chances of
repair. After you have the op note, phone our office manager
for a fax number. Dr. Doody will personally read the report (for free) and get back
to you.)
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| Do I want to do this, or is this only for my partner? (One
of the most common reasons for a tubal reversal is remarriage to a new husband who has
never had children. The decision to try to have another child in this situation has
generally been made before the remarriage.)
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| If I do really want to do this, how does my partner feel?
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| Can we afford this now?
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| Are there spiritual aspects to this decision? (Pray about it!)
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| Would the availability of low interest financing
make this procedure more attractive as an option?
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| Can we afford a baby? (Go to www.babyzone.com
or www.babycenter.com for tons of information on
this subject. These are huge sites, so don't forget to bookmark this site before you go.)
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| I am overweight. Can I still have this procedure done? (Yes, but
it may affect the way the procedure is done.)
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| I am latex allergic. Can I still have this procedure done? (Yes.)
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| Is the wife's age such that fertility is decreasing? (This
starts in women after age 35 to some extent and is a major factor after age 40.)
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| If over age 35, should we speed things up or on the other hand
consider not doing the procedure?
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| How many children will we want in the future?
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| What will a new child do for me? My partner? My other children?
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| Is the doctor that I am considering a subspecialist? (His or her
web site would probably say so. If not, simply phone to ask the office receptionist
"Is the doctor a Reproductive Endocrinologist?" This is an assurance of
completion of the basic years of microsurgical training and a real commitment to
reproductive problems. Because of the wide number of choices available to you, you need at
least one "litmus test" for this life-altering decision. This is one of
them. If for whatever reason you do not conceive in the future, you do not want to have any
regrets about how you chose the surgeon. )
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| Do I understand what is involved with the operation?
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| Is In Vitro Fertilization a better option for me at this
time? (If cost is not a major factor but time is, then IVF may be the better option.
On a "dollars per baby" basis, tubal reversal is over twice as effective as IVF,
but the results of IVF are known much faster. Generally, the wealthier a couple is, the
more attractive IVF seems. On the other hand, tubal reversal allows the option to have
more than one pregnancy in the future. Building a large family with IVF would require
multiple procedures. Multiple pregnancies are NOT a good outcome, and approximately 30-40%
of the pregnancies with IVF are multiples! Tubal ligation reversal does not increase your
chance of having a multiple pregnancy.)
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| Is adoption a better option for us at this time? (Adoption is
usually more expensive than tubal reversal, but it may be a better choice for a much older
couple.)
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| If I am a smoker, can I quit in order to give myself a better
chance? (You will have to quit when you become pregnant anyway!)
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| Were the previous pregnancies healthy? If not, are these problems
likely to return?
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| Are there new medical problems now which might influence a
pregnancy? (If so, ask the doctor who is taking care of them whether a pregnancy would be
possible.)
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| What are the costs involved in travelling to have this done? ( www.travelocity.com can give you a quick estimate of
airfare. You will have to fill out a short registration form, but this is not a commitment
to buy tickets on the flights you are asking about. Ask about flights more than one month
in advance to get the best quotes. Remember to add in the cost of several nights in a
hotel room. Our offices can give you the phone numbers of inexpensive hotels nearby. )
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| How important is a financial guarantee to
me? (Beyond the financial implications of a guarantee, keep in mind that it is an
excellent indicator of a doctor's success rate as well.)
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| We are really interested in the kinds of things that people think
about as they make this decision! What are you going through? If there are other points we
should include on this page, please send us a quick
email. |
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