Where do eggs go after tubal ligation. Can women with tied tubes donate eggs. What are the options for fertility after tubal sterilization. How does tubal ligation affect egg production and ovulation. What are the pros and cons of tubal reversal surgery vs. IVF.

The Biological Process After Tubal Ligation

Tubal ligation, commonly known as “getting your tubes tied,” is a surgical procedure for female sterilization. But what happens to a woman’s eggs after this procedure?

After tubal ligation, the ovaries continue to produce eggs as they normally would. The key difference is that the eggs can no longer travel through the fallopian tubes to reach the uterus. Instead, they are absorbed by the body.

The Fate of Eggs Post-Ligation

When an egg is released from the ovary during ovulation, it typically travels down the fallopian tube. In women who have undergone tubal ligation, this path is blocked. As a result:

• The egg cannot reach the uterus
• Sperm cannot reach the egg
• The egg is reabsorbed by the body
• Hormonal cycles continue as usual

This process of reabsorption is natural and does not cause any harm to the woman’s body. It’s similar to what happens to unfertilized eggs in women who haven’t undergone tubal ligation.

Egg Donation After Tubal Ligation: Is It Possible?

Many women who have undergone tubal ligation wonder if they can still donate their eggs. The answer is yes, it is possible to donate eggs even after having your tubes tied.

Tubal ligation does not affect egg production or quality. The ovaries continue to produce eggs, and these eggs can be retrieved for donation through a process called transvaginal oocyte retrieval.

The Egg Donation Process for Women with Tied Tubes

The process for egg donation after tubal ligation is essentially the same as for women who haven’t had the procedure:

1. Hormonal stimulation to encourage multiple egg production
2. Monitoring of egg development through ultrasounds and blood tests
3. Egg retrieval using a needle guided by ultrasound
4. Processing and freezing of retrieved eggs

The only difference is that in women with tubal ligation, there’s no risk of unexpected pregnancy during the stimulation phase.

Fertility Options After Tubal Ligation

For women who have had tubal ligation but later decide they want to conceive, there are two main options: tubal reversal surgery and in vitro fertilization (IVF).

Tubal Reversal Surgery

Tubal reversal surgery aims to restore fertility by reconnecting the fallopian tubes. This procedure:

• Requires a larger incision than the original ligation
• Has a longer recovery time
• Can be successful in restoring natural fertility
• Is not always possible, depending on the type of ligation performed

In Vitro Fertilization (IVF)

IVF bypasses the need for open fallopian tubes by fertilizing eggs outside the body. This process:

• Involves hormone stimulation and egg retrieval
• Fertilizes eggs in a laboratory setting
• Transfers resulting embryos directly into the uterus
• Can be successful even when tubal reversal is not possible

The choice between these options depends on various factors including age, overall fertility, and personal preferences.

Understanding the Types of Tubal Ligation

There are several methods of tubal ligation, each with different implications for future fertility options:

• Tubal Clips (clamps): Small clips are placed on the fallopian tubes
• Tubal Rings (bands): Elastic bands are wrapped around sections of the tubes
• Resection: Portions of the tubes are cut and tied
• Coagulation: The tubes are sealed using electric current
• Fimbriectomy: The fimbriated ends of the tubes are removed
• Essure: A newer method involving the insertion of coils into the tubes

The method used can affect the success rate of tubal reversal surgery and may influence the decision between reversal and IVF.

The Impact of Tubal Ligation on Hormones and Menstrual Cycle

A common concern among women considering tubal ligation is its effect on hormones and menstrual cycles. It’s important to understand that:

• Tubal ligation does not affect hormone production
• The menstrual cycle continues as normal
• Ovulation still occurs monthly
• The procedure does not induce menopause

Any changes in menstrual patterns after tubal ligation are typically due to stopping hormonal birth control rather than the procedure itself.

Considerations for Tubal Reversal Surgery

When contemplating tubal reversal surgery, several factors come into play:

Success Rates

The success of tubal reversal surgery depends on various factors:

• Age of the woman
• Type of tubal ligation performed
• Length of remaining fallopian tubes
• Overall fertility health

Success rates can range from 40% to 85%, with younger women generally having higher success rates.

Surgical Procedure

Tubal reversal surgery is more complex than the original ligation:

• Requires a larger incision (4-6 inches)
• Performed under general anesthesia
• Takes 2-3 hours to complete
• Requires microsurgical techniques

Recovery Time

Recovery from tubal reversal surgery is longer than from the original ligation:

• Hospital stay of 1-2 days
• 2-3 weeks before returning to normal activities
• 6-8 weeks before attempting conception

Costs

Tubal reversal surgery can be expensive:

• Costs range from $5,000 to $21,000
• Often not covered by insurance
• May require travel to a specialized facility

In-Depth Look at IVF After Tubal Ligation

In vitro fertilization (IVF) is a widely used alternative to tubal reversal surgery for women seeking pregnancy after tubal ligation.

The IVF Process

IVF involves several steps:

1. Ovarian stimulation with hormones
2. Egg retrieval
3. Sperm collection
4. Fertilization in the laboratory
5. Embryo culture
6. Embryo transfer to the uterus

Success Rates

IVF success rates vary based on several factors:

• Age of the woman
• Overall fertility health
• Quality of embryos
• Expertise of the IVF clinic

On average, IVF success rates range from 20% to 35% per cycle for women under 35.

Advantages of IVF

IVF offers several advantages over tubal reversal:

• Less invasive procedure
• Can overcome multiple fertility issues
• Allows for genetic testing of embryos
• Option to freeze additional embryos for future use

Considerations for IVF

While IVF is a powerful tool, it’s important to consider:

• Higher cost per attempt compared to natural conception
• Emotional and physical stress of the process
• Potential for multiple pregnancies
• Need for multiple cycles in some cases

Making the Decision: Tubal Reversal vs. IVF

Choosing between tubal reversal and IVF is a personal decision that depends on various factors:

Age

Age plays a crucial role in fertility treatment success:

• Women under 35 may have better success with tubal reversal
• Women over 40 may benefit more from IVF

Fertility Factors

Other fertility factors to consider include:

• Sperm quality of the partner
• Presence of other fertility issues
• Overall reproductive health

Cost Considerations

Financial aspects often play a significant role:

• Tubal reversal is usually a one-time cost
• IVF may require multiple cycles, increasing overall cost
• Insurance coverage varies for both procedures

Long-term Family Planning

Consider your long-term family goals:

• Tubal reversal allows for multiple natural pregnancies
• IVF provides more control over timing and number of pregnancies

Ultimately, the decision should be made in consultation with a fertility specialist who can provide personalized advice based on your specific situation.

Psychological and Emotional Aspects of Post-Tubal Ligation Fertility

The journey to conceive after tubal ligation can be emotionally challenging. It’s important to address the psychological aspects:

Dealing with Regret

Many women experience regret after tubal ligation:

• It’s a common and valid emotional response
• Counseling can be helpful in processing these feelings
• Support groups for women in similar situations exist

Emotional Stress of Fertility Treatments

Both tubal reversal and IVF can be emotionally taxing:

• The uncertainty of success can cause anxiety
• Hormonal treatments may affect mood
• Financial stress can add to emotional burden

Coping Strategies

To manage the emotional aspects, consider:

• Seeking professional counseling
• Joining support groups
• Practicing stress-reduction techniques
• Open communication with your partner

Remember, it’s normal to experience a range of emotions during this process. Seeking support and maintaining open communication can help navigate these challenges.

Important Facts About Fallopian Tubes After Tubal Ligation

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Doctor Who Performed Surgery *Dr. William Greene Jr.Dr. Wendell A. Turner

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How to get pregnant after your tubes are tied

Tubal reversal surgery or IVF, in vitro fertilization, after tubal ligation

Bundled price for tubal reversal of $9,000, including our fees, the surgery center and anesthesia.

Women who have had tubal ligations sometimes regret their decision and desire fertility in the future. There are 2 options for fertility after tubal ligation, tubal reversal surgery and in vitro fertilization – IVF. Both of these are reasonable options and how the woman chooses to proceed should be based on an educated consideration of the pros and cons of each.

Most women have their tubes tied before they leave the hospital after they deliver a baby, or they come in for tubal ligation by laparoscopy which is an outpatient surgical procedure done through a scope that goes through the belly button.

Tubal reversal surgery usually requires a laparotomy which is a much larger incision on the abdomen usually approximately 4 to 6 inches in length. Since the skin and all the muscles and other tissues of the abdominal wall must be cut through there is considerably more discomfort and a much longer recovery time following the surgery as compared to a laparoscopic surgery such as with a tubal ligation.

Some surgeons are now performing tubal reversal surgeries through the laparoscope. However, this is a relatively difficult technique and there is not yet sufficient published data to know what pregnancy rates will be after laparoscopic tubal reversal.

Most women will need to be in the hospital for approximately 3 days following tubal reversal surgery and will need to be off work for a minimum of 2 to 3 weeks.

There are 5 important issues regarding tubal reversal surgery that need to be considered and discussed. The sperm quality of the male partner, tubal status, status of other possible pelvic conditions, female age, and egg quantity and quality.

Sperm quality

The male partner needs a sperm test prior to decision making about tubal reversal vs. IVF after tubal ligation. If the sperm quality is good, then the couple could possibly consider both options. If the sperm quality is poor, in vitro fertilization is the better option. This is because pregnancy rates are low without using in vitro fertilization if there is poor sperm quality (low sperm count or motility). With IVF with ICSI, poor sperm quality is easily overcome.

Tubal status

The length of the remaining tubal stumps after tubal ligation (or cauterization if the tubes were burned instead of tied or clipped) is very important. The longer the 2 remaining stumps are on each side the better the chances for successful reversal and pregnancy. The shorter the stumps the lower are the chances for pregnancy.

Unfortunately, it can not be known how much tube is remaining for certain without surgery. A hysterosalpingogram (dye test in radiology) can tell us how long the proximal stump is (the piece of tube attached to the uterus) but the dye test will not tell us anything about the length of the distal stump (the far end of the tube that has been separated from the uterus).

Some women go through tubal reversal surgery with very short tubes. This results in low chances for subsequent pregnancy.

The fimbria are delicate, fluffy structures at the end of the tube that “pick up” the egg when it is released from the ovary at the time of ovulation. If the fimbriated end of the tube is damaged or has been removed, chances for success with reversal are low.

Laparoscopy picture showing delicate fimbria (F) at end of normal fallopian tube (T)
The fimbria are close to the ovary so it can pick up the egg at ovulation

If both portions of fallopian tube are significant long (sometimes they are quite short), the fimbria are in good condition, and the surgery is done expertly, the expected pregnancy rate in young women (under 35) without other fertility problems (male partner also has good sperm quality) should be about 75%.

This means that after 1 year of trying 75% of women should be able to get pregnant if the tubal anatomy was good and these other factors are all normal. If any of these factors are abnormal, expected pregnancy rates after tubal reversal would be significantly lower.

Status of any other pelvic conditions

Pelvic endometriosis or any scar tissue in the area of the tubes or ovaries would be expected to reduce the chances for success after tubal reversal surgery. However, IVF pregnancy success rates are generally not affected by these conditions. Therefore, in vitro fertilization is probably a better option in women with significant endometriosis or pelvic scar tissue.

Female age

Chances for pregnancy with either tubal reversal or IVF decline in the mid to late 30’s and more dramatically starting at about age 38. By age 43-44, very few women will be able to have a baby using either approach. This issue makes careful and honest counseling very important for women between about 35 to 43 years of age.

I would discourage women 43 and older from pursuing either option because of the dismal success rates at that age and beyond. Egg donation is a more viable option iat that age.

Egg quantity and quality

Some women have a decline in either egg quantity or quality earlier in life than expected. Therefore, the woman’s “ovarian reserve” should be tested before a decision is made regarding whether to proceed with either tubal reversal or in vitro fertilization. Ovarian reserve is usually assessed by an ovarian antral follicle count, ovarian volumes and day 3 FSH levels.

Tubal reversal surgery

The biggest advantage of tubal reversal surgery over IVF is that once the women has gone through the surgery she hopefully will not need any intervention through a physician such as drugs, medications or procedures in order to get pregnant. Obviously, the idea is that good old fashion sex will then give them the baby that they want.

There is also very low risk for multiple pregnancy – twins occur naturally in only 1 in 90 pregnancies. The biggest disadvantage is the fact that the women has to go through a big surgery and if pregnancy does not result after the tubal reversal her only option remaining is in vitro fertilization.

A small disadvantage is that after she has her additional child (or children), she will need to use contraception or have her tubes (or her male partner’s) tied again.

In vitro fertilization – IVF

In vitro fertilization involves stimulating the woman with medications, taking a number of eggs from her ovaries, fertilizing them with her male partners sperm and transferring some of the resulting embryos back into her uterus with the hope that one will implant. There is detailed information elsewhere on this site about in vitro fertilization.

The biggest advantage of in vitro fertilization is that the woman can avoid avoids the major surgery involved with a tubal reversal. Another advantage is that the outcome is known 10 days after the procedure when we do the first pregnancy test rather then waiting for a year or more to find out whether the procedure is successful.

Success rates with IVF vary greatly according to the program. Some IVF programs have pregnancy rates with tubal factor infertility of over 50% per attempt in women under 40 years old. Other programs with the same type of patients report pregnancy rates of only 20 to 30% (or sometimes less).

The reason for this is that some in vitro fertilization programs are better than others. This is why the couple should do careful comparisons of in vitro fertilization success rates before choosing an IVF specialist and clinic.

The biggest disadvantages of in vitro fertilization are that the woman has to take medications to stimulate development of multiple eggs and that there is always some risk for multiple pregnancy.

The biggest disadvantages of in vitro fertilization are that the woman has to take medications to stimulate development of multiple eggs and that there is always some risk for multiple pregnancy.

However, multiple birth risks can be controlled by limiting the numbers of embryos transferred to 1 (or 2). Another disadvantage is that if the first attempt does not work the couple must do IVF again. Often there would be left over embryos that were frozen from the first cycle – it is much less expensive and easier for a second attempt using the frozen embryos. However, if there are not any frozen embryos, the cost for the second attempt is usually the same as for the first one.

Costs for tubal reversal surgery and IVF costs

Physician charges for tubal reversal surgery and for IVF vary greatly across the country. Most physicians charge a professional fee of somewhere between $3000 and $8,000 for the tubal reversal surgery. On top of this will be hospital charges which are usually between $7,000 and $20,000. Insurance will rarely pay any of these charges.

• We have a bundled price for tubal reversal of $9,000 – includes our fees, surgery center and anesthesia

IVF costs between about $7,000 and $17,000 plus medications depending on the program. Medication costs vary according to the amount needed for the individual woman, but average about $2500 – $3000 for the cycle.

• Our IVF cycle package cost is $10,000 plus medications
• We also offer a multiple cycle IVF plan and a money-back guarantee IVF pricing option

There is no correlation between the price programs charge and the pregnancy success rate. Some of the most expensive programs have very low pregnancy rates and some of the lower cost programs have very high pregnancy rates. “You get what you pay for” does not necessarily apply for in vitro fertilization.

Women that have had tubal ligations often ask us:

“What is the best way for me to have another baby, should I do IVF or should I have the tubal reversal surgery?”

I do not believe that there is a “best” way. The best way to try to have another baby for an individual woman is up to her. She needs to learn about the pros and cons of both approaches and then consider risks, benefits and costs involved with each one.

Having said all of this, very few women come in asking for reversal surgery anymore. They almost always have read about both options and want in vitro fertilization. The OB/GYN physicians are most often telling them to go for IVF as well. If we had a crystal ball that would tell us what, if anything, would get the couple a baby it would be easy to decide.

If anyone has such a crystal ball for sale, please call me immediately. I will pay very well for it…

For more information about details regarding tubal reversal surgery and IVF, there are many other pages on this website related to both tubal surgery and in vitro fertilization.

Removal of fallopian tubes – methods of operation and consequences

A woman’s fallopian tubes are removed only as a last resort. The operation is not planned in advance, so a woman cannot have time to prepare for such a disaster and give birth to a child. What to do now? Is there any chance of getting pregnant?

About fallopian tubes

Everyone knows that the fallopian tubes are needed for pregnancy. But for what exactly? In fact, these organs are just “conductors” for the egg (oocyte).

The egg is formed in the ovaries, bean-shaped organs that are located on the sides of the uterus and above it, but are not connected with it in any way. During ovulation, the oocyte enters the pelvic cavity and, theoretically, can settle anywhere: on the intestines, on top of the uterus, on the fallopian tubes, and on the ovary itself. But fertilization must take place inside the uterus.

In order for the egg to reach the uterine cavity, the fallopian tubes are needed. At their end there are “cilia”. They, contracting, create such a wave in the pelvic cavity, which “drives” the oocyte inside the fallopian tubes and conducts them to the uterus. But if there are no fallopian tubes, there is no one to “catch” and “see off” the egg every month.

There is a way out!

Unfortunately, organs such as the fallopian tubes have not yet learned how to make artificially. Although attempts have been made. Theoretically, it is possible to make tubes of this diameter from a person’s own intestines, and you can even sew them to the uterus, but they will not be able to contract – the egg will stop in them and collapse after a while. But do not rush to get upset!

If only the fallopian tubes are removed, and at least one ovary remains, you can get pregnant using in vitro fertilization (IVF). It involves the isolation of an egg separately, a separate spermatozoa, with their subsequent connection in a test tube. When doctors are convinced that such a fusion resulted in an embryo (usually there are several of them at once, since several eggs are taken), it is introduced into the uterine cavity and all conditions are created so that it is fixed there. Throughout the pregnancy, a woman will be helped to maintain such a hormonal background in order to eliminate the risk of miscarriage or premature birth.

And if the fallopian tubes are removed with the ovaries?

This is a very sad situation in which a woman’s eggs are not synthesized at all. However, there is a way out of it. This is IVF with donor oocytes.

The essence of the procedure is as follows. There are women who want to earn money by donating their own eggs. They are examined, healthy and ready for hormonal stimulation, which will lead to the maturation of their own oocytes. If you conclude an agreement with such a woman, after a time when her eggs mature, you and your husband will be called to the clinic. Doctors will need to fertilize her cells in a test tube with your spouse’s seminal fluid.

From this moment on, you will need to take hormonal drugs already – in order to prepare the body for a future pregnancy. If the embryos are developing normally, after about 5 days they will come back to the clinic: the prepared embryos (they will be pre-examined for genetic diseases) will be introduced into your uterus. The procedure takes about 10 minutes, after which you need to lie down for another 2-3 hours – and you can return home.

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Why women experience infertility

Infertility is the inability of a couple of childbearing age to conceive a child with regular sexual activity.

A married couple is considered infertile if a woman’s pregnancy does not occur within a year of regular sexual intercourse (sex at least 2 times a week) without the use of contraceptives and methods.

The causes of female infertility can be:

Obstruction or absence of the uterine, or fallopian tubes , into which the egg enters after ovulation and where it meets with spermatozoa. In the distal parts of the fallopian tubes, the meeting and fusion of the sperm with the egg occurs, that is, fertilization occurs, as a result of which an embryo is formed. The embryo moves through the tube into the uterine cavity due to contractions of the muscular wall of the tube (peristalsis) and cilia (the epithelium lining the tube from the inside), which “drive” the embryo into the uterus. Obstruction of the fallopian tubes, as a rule, is the result of an adhesive (adhesive) process, which leads to inflammation of the tubes (salpingitis). Sometimes this is the result of a woman’s sterilization (ligation or intersection of the fallopian tubes). The absence of the fallopian tubes is observed after the surgical removal of the tube, for example, in connection with an ectopic (tubal) pregnancy or a purulent process in it (pyosalpinx).

Adhesions in the pelvis (peritoneal infertility factor) is a consequence of operations, inflammation, endometriosis. Adhesions may envelop the ovary or be located between the tube and the ovary, preventing the egg from entering the tube. With a combination of tubal and peritoneal factors, they speak of tubal-peritoneal infertility.

Endocrine (hormonal) disorders – may be the result of pathology of the ovaries (their exhaustion, polycystic ovary syndrome, etc.) and other endocrine (hypothalamus, pituitary, adrenal glands, thyroid) and non-endocrine organs (liver, kidneys, etc.) . Endocrine infertility can be caused by metabolic disorders, mental stress, etc. Whatever causes endocrine infertility, its key point is always a breakdown of the ovulation mechanism (anovulation).

Pathology or absence of the uterus – the organ in which the embryo is implanted and the fetus is gestated. Uterine pathology can be congenital (intrauterine septum, bicornuate uterus, uterus doubling, etc.) and acquired (removal or scarring of the uterus after surgery, uterine fibroids, endometritis, adenomyosis, polyposis, endometrial hyperplasia, etc.).

Endometriosis , which is expressed in the growth of the uterine mucosa (endometrium) outside of it.