After Tubal Ligation - Tubal Reversal for Fallopian Tubes or IVF?

Are you in the situation where your life has changed following your tubal ligation?  Now, you want a baby and here you sit with blocked fallopian tubes.  What are you going to do?

If you are like most women, your first stop is your own family doctor.  Most likely he is going to tell you that having your tubes tied is permanent and your only recourse is IVF at a fertility center.  If you are lucky, he may have heard of tubal reversal surgery, but, again, most likely, thinks it has an abysmal success rate.  Are either of these myths real?

Well, if you read the last paragraph, you did learn that IVF is not the only recourse you have.  If you have been searching the Internet, you also know this is true.  The alternative for a pregnancy after tubal ligation is tubal reversal surgery.  In this surgery, the blockage is removed from your fallopian tubes and then the tubes are recombined.  

So the next question should be which one has the better success rate.  It should be the next question, but I'm betting you really want to know the cost of each option first.  Let's quickly look at that with the average costs.

The first problem is that you are not comparing apples to apples.  The average cost for a tubal reversal in the U.S. is $8,000 - $9,000.  That is for the onetime surgery.  

The average cost for IVF is $10,000 - $12,000.  However, that is on a per cycle basis which means if one cycle fails, you have to pay again to try again.  Using frozen embryos from the first try, if available, might make the cycle cost go down as the techs won't have to do the fertilization in the Petri dish part again nor over stimulate your ovaries to produce more eggs though your uterus still needs to be prepared for implantation.  That should make it safer on you as well, at least the second and third times, if enough embryos have been frozen.

OK, so the cost question is out of the way but comes back up again later.  Let's look at the success rate.  Using a CDC report, we find that the pregnancy rate for IVF is 35% for all the cycles in the data that made it past the initial stages.  There were about 11% of tries that didn't make it even to the egg collecting part due to one problem or another.  But of those that did, barely more than a third resulted in a pregnancy.  I won't even talk about the actual live birth rate.  You can check that out in the CDC's report yourself.

Turning to tubal reversal where your fallopian tubes are actually repaired allowing you to try for a natural pregnancy, we find that there is no CDC report available.  That's where one tubal reversal center stepped in and collected data on over 5000 women.  From their results, they found tubal reversal to have an overall 66% pregnancy rate over time.  Unlike the alternative, you can try and try again each month to make a baby for the same cost.  Hmmm, looks better than IVF to me.  

Now I need to point out one thing to be sure you noticed it.  When your fallopian tubes are repaired by tubal reversal surgery, you can try each month (and several times a month) to get pregnant.  With IVF, it's one shot and then there is recovery time before you can try again.  With a less than 35% chance of having a baby that way, you are going to be trying again.  And that leads to my point.  Each time you try with IVF, you pay till you get the baby or you give up.  So which do you think is the better alternative after tubal ligation?