With more than a quarter-century of experience in tubal reversals, The Reproductive Science Center of the San Francisco Bay Area is the largest provider of ambulatory (out patient) MTR in Northern California, and one of the few programs in the United States that provides complete out-patient treatment on site in a nationally accredited facility. Dr. Galen was also the first surgeon in the United States to perform laparoscopic tubal reversal surgery using the new computerized robotic system introduced in August, 2000.

Benefits of MTR

High successful pregnancy rates – Pregnancy rates following tubal reversal in the RSC program average 80 percent in women younger than 39. Specific success rates also depend on the woman's age and type of prior sterilization procedure performed. Additionally, many published journal articles have demonstrated that pregnancy rates are heavily dependent on the skill of the surgeon.

The average time between reversal and pregnancy is seven months. Women who had sterilization treatment that causes minimal tissue damage (such as clips, Falope Ring, Pomeroy, or Bipolar coagulation) are most favorable for reversal. If a fimbriectomy has been done or a large portion of the woman's tube removed, reversal efforts are usually not successful. In these cases, in vitro fertilization (IVF) is recommended.

Candidates

Women who have undergone sterilization with minimal tissue damage are candidates for this procedure, as long as the woman and her partner are otherwise fertile.

Before surgery, the couple consult with a physician to evaluate factors that may affect future fertility. The physician reviews a copy of the sterilization operative report, and if the report is not conclusive that the patient will be an acceptable candidate, the patient may need a preliminary laparoscopy. The physician usually orders a semen analysis and, depending on the woman's age, a Clomiphene Challenge Test. If both are normal, then microsurgical tubal repair can be scheduled

Risks

Microsurgery requires a surgeon who understands tubal physiology. It also requires meticulous control of bleeding, extremely gentle tissue handing, precise dissection, and exact placement of sutures in order to maximize the patient's future pregnancy rates.

Surgical risks include bleeding, infection, anesthesia, and injury to other structures, although these are rare. In the past 25 years of tubal microsurgery, RSC physicians have experienced virtually no complications in any patient.

Procedure

The actual surgery is performed under general or regional anesthesia, and average operating time is two hours. Patients rest for two to four hours in a recovery room before returning home. At home, patients should have minimal activity for several days, and most women are able to return to normal activities within two to three weeks.

Cost

Since most insurance plans do not cover the cost of tubal reversal surgery, patients will realize the advantages in programs that demonstrate high success rates as well as lower costs. Because RSC has an on-site operating room, it can offer these services at substantially lower costs than other hospitals in the area. RSC’s costs are typically one-third to one-half the cost at other centers. In my 27 year experience as a microsurgical tubal reversal expert, I have found that the vast majority of women with prior sterilization can successfully have their tubes reopened.