You thought you were done having children and had your tubes ligated (commonly referred as “tubes tied”). You did this sterilization procedure during your most recent cesarean section or shortly after birth. While initially the blocked fallopian tubes where a desired solution, you might now deeply regret your choice. You might have a second marriage or a new partner with a desire for more children.
You might be wondering if it is possible to reverse the tubal ligation. We hear this story over and over and we do have the expertise and microsurgical skills to help you! And yes, you can skip surgery and get pregnant with in-vitro fertilization (IVF). However, this is usually a more expensive and unnatural way to get pregnant. Your alternative is to repair your tubes using a surgical reversal of the previous ligation. Tubal ligation reversal in Los Angeles can help you restore your tubal function.
Tree of life Center tubal reversal experts perform tubal ligation reversal microsurgery at a premier surgical suite in Westlake Village, Calabasas or Beverly Hills, California. Since the introduction of IVF, few fertility clinics in the United States still offer tubal reversal surgery.
You do not need to look for any other places to get your tubes untied. In our center for tubal reversal you will have your tubal repair performed by physicians board-certified in reproductive medicine directly in Los Angeles. Not only we will fix your tubes, but we can provide you with a comprehensive fertility assessment of your particular situation.
The tubal reversal surgeries is performed by creating an incision at the bottom of your abdomen. The mini-laparotomy incision is smaller than a typical cesarean section incision and very low on the abdomen. It needs to be just large enough to lift your uterus out of the abdomen. It is generally 2-3 inches in lenght. This is sufficient to allow exposure of your tubes.
The surgeons then use microscopic glasses or a surgical microscope to visualize all details of your fallopian tubes. The ligated (cut, burned, clipped, tied) part of the tube is removed and the ends freshened up so they can be reconnected using microscopic sutures. We typically place at least four microsurgical stitches to reconnect the tube.The surgical instruments used are delicate, small and specifically designed for microsurgery. This allows minimal tissue trauma, a perfect re-connection of your tubes and reduction of scar formation after surgery.
Following the reversal, we flush the tubes with blue dye (methylene blue - did you see the blue syringe in picture picture above?) to confirm that your "untied" tubes are indeed open. The uterus is then returned into the abdomen and the abdominal incision heals within 2-3 weeks. We never use surgical staples and always close your incision to look beautiful with sutures. This makes the scar almost invisible. It can take up to 6 weeks until complete recovery.
Alternatively, the tubal ligation can be performed with laparoscopy. This avoids creating the abdominal incision and can be accomplished with 3-4 very small keyhole incisions on your abdomen. A camera and long microsurgical instruments are introduced into the abdomen. In some cases a surgical robotic device (DaVinci Robot) can also be used to perform this procedure. Dr. Jovanovic is a certified DaVinci robotic surgeon.
The postoperative recovery after laparoscopy can be faster than using the slightly larger mini-laparotomy incision. However, the laparoscopic or robotic reversal prolongs the surgery time and utilizes more expensive equipment. Given that tubal reversal surgery is not a covered health insurance benefit, any form of laparoscopy will significantly increase your surgery costs. Most for our patients do not have unlimited budgets and opt for a more affordable solution and don´t mind a small abdominal incision above the pubic hairline.
Not everyone is a candidate for tubal reversal surgery. The remaining fallopian tubes might have more or less damage. This depends on the method of ligation. It is therefore very important to review your ligation medical records. We will check how the tubes were ligated before scheduling you for the surgical procedure.
Best circumstances for the tubal reversal procedure are provided when a clip, ring or sutures were used for ligation. In some patients, the entire tubes might have been removed during the sterilization procedure, which makes a reversal impossible. When tubes were burned with electricity, the associated thermal damage might spread well beyond the burned spot. In cases of extensive damage, your tubes might be irreparable.
In order to avoid finding out surprises in the operating room we always request your sterilization operative report in advance. We do not want to put you in the situation of having an abdominal incision and not being able to repair your tubes. We will review your records free of charge and provide you with expert recommendation if you are a good candidate for tubal reversal. Once we complete our tubal specialists review, you will be able to make informed decisions how to proceed.
We will ask your partner to perform a semen analysis. In case of a male factor fertility problem, the tubal repair alone might be insufficient to restore your fertility. In those situations the reversal might be a very bad choice. We strongly recommend you to check your partner’s sperm and ensure that his sperm parameters are adequate for conception afterwards. In some cases you might still be single and we will not require a semen analysis.
Any surgery bears risks of infection, bleeding and damage to surrounding organs. There is also the risk of medical complications during anesthesia. Your overall medical fitness plays a role when addressing your individual risks. The risks are mitigated since the uterus is lifted out of the abdomen as seen in the photo at the top of this page. This ensures that any vital organs remain protected inside of your abdomen. The uterus and tubes are the only organs exposed to the surgical instruments.
The risk of ectopic pregnancy is one of the complications that may arise from the tubal reversal surgery. Once pregnant after reversal, you need to immediately schedule an early obstetrical ultrasound. The ultrasound will confirm that the pregnancy is in the uterus and not in the fallopian tube anastomosis.
The success rates after the tubal reversal surgery will greatly depend on your age. Ideally, tubal reversal surgery is performed at younger ages when pregnancy rates are naturally high. However, some of our older patients do not respond well to hormonal stimulation and might make poor candidates for IVF. In such cases, tubal reversal surgery might be the preferred solution. The huge advantage is that a successful reversal allows you to attempt conception for many months to come. The menstrual cycles following the surgery will give you multiple chances of pregnancy resulting from a single surgical intervention. If the same woman undergoes repeated cycles of IVF, the cost would be very high. This is because each monthly attempt (cycle) of in vitro fertilization creates a separate additional charge. Getting pregnant after tubal reversal comes with no charge and can actually be much more fun than IVF!
We always recommend you to take advantage of our initial consultation, since each individual situation might be different.
The Tree of life Center can re-establish your fertility and perform tubal reversal surgery for less than $6000. This pricing is very competitive and comparable to some international centers outside of the United States that claim to be inexpensive. Our physicians both perform tubal reversal surgery and are also experts in any other area of reproductive medicine. We are able to treat and advise you how to increase your fertility success rates after successful reversal surgery. The outpatient surgery is performed in Encino, Beverly Hills or Westlake Village in a premier outpatient surgical center. We will help you during your post-operative period so that you can increase your chances of success. We are also experts all kinds of in vitro fertilization at Tree of Life Center. If for whatever reason you do not become pregnant after surgery, we will help you with a discount towards in vitro fertilization treatment.
Please call us to further discuss your options and suitability for tubal reversal surgery. We will offer you a courtesy review of your medical records. Please ensure that you collect all your records prior to scheduling a consultation.
I had surgery by Dr. Jovanovic last year and he has done a stellar job. He was the only doctor (I saw about 7) who sat and listened to me. Really LISTENED. He never pretended he had all the answers, he just gave me his honest opinion. The whole experience with him was fantastic, I couldn't have asked for a better physician. I would highly recommend Dr. J. because he listens, he cares and he's honest.
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