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Tubal Reversal or IVF?

Posted Mar 02 2009 5:00am
 Specializing in tubal surgery and the treatment of infertility in women who have had tubal ligations (tubes tied), we meet many patients who share many different stories with us. In the fall of 2008, I was conducting a preoperative evaluation with a patient for a tubal ligation reversal after she had an unsuccessful IVF treatment cycle.  Here is her story.

Limits of Reproductive Freedom in the United States:
The Story of Cyndi and Steven

Cyndi is a 35 year old hospital administrator from Arkansas and a mother of two teenage children. Steven is 34 years old and has no children. He is also a hospital administrator in the department of mental health.

Eleven years prior to meeting Steven, Cyndi was in an failing  marriage in which she felt desperate. After having two children with her husband, Cyndi had a tubal ligation at the age of 24. Cyndi had her tubes tied because she felt trapped and she had resolved never to have another child with her husband. She eventually divorced and became a single parent. She now wants to have children with Steven.

Quest for a Tubal Ligation Reversal

Cyndi and Steven are not married, but they want to become parents together. Searching on the internet for “tubal ligation reversal”, they found Chapel Hill Tubal Reversal Center. Cyndi sent her medical records to be evaluated for reversal of tubal ligation.  Before deciding to come to Chapel Hill, they made an appointment with a local infertility specialist in Arkansas to inquire about having her tubes untied. Her physician reviewed her tubal ligation operative report and ordered a hysterosalpingogram (HSG). They were told this was necessary before having  tubal reversal surgery. The cost for the initial evaluation of Cyndi’s infertility was $3300. After her HSG, the infertility doctor told her in vitro fertilization (IVF) would be a better alternative for her.

According to Cyndi, two statements the doctor made are clear in her memory:

“Your tubes can not be repaired based on the HSG report and operative note.”

“Pregnancy results are statistically better with IVF.”

Cyndi felt they were talked into IVF by the doctor. Cyndi says that she and Steven are impatient, and they were lured by the quick pregnancy results promised by IVF. Cyndi was told that one more test would be required before starting IVF, and the money paid to be evaluated for  reversal surgery would be deducted from the total cost of IVF.

Then They Discovered No Marriage Equals No IVF!

After making the decision to proceed with treatment by IVF,  rather than tubal reversal surgery, Cyndi called her infertility doctor’s office to schedule the last required test in order to start her IVF cycle. She was shocked by the response given by the nurse.

Cyndi was told IVF treatments would not be provided to her because she and Steven were not married. The nurse informed Cyndi the state law of Arkansas does not allow IVF treatments for unmarried couples, and they would have to travel out of the state for IVF treatment.

Cyndi felt she had not been given complete information about IVF at the onset. At the beginning of their evaluation, they had filled out forms stating they were not married. Despite the fact they were encouraged to have IVF throughout their evaluation, neither the doctor nor the staff told them IVF would be illegal in Arkansas because they were not married. Only after several doctor’s visits, medical tests, and more than $3000 spent, were Cyndi and Steven told they were not allowed to have IVF treatments in her home state of Arkansas.

Why Does Cyndi Not Want to Remarry?

Cyndi says she has great love for Steven and wants to have his child, but she does not want to set herself up for another failed marriage. In listening to Cyndi, I sensed that she has insight and maturity taught to her by some of her life’s past bitter lessons. She seemed to face her challenges with both calm and resolution.

Part II of Cyndi’s Story

The second part of this article, Tubal Ligation Reversal After Failed IVF, describes Cyndi’s failed IVF treatment cycle and her ultimate decision to have a tubal ligation reversal.

Chapel Hill Tubal Reversal Center

The tubal reversal doctors Chapel Hill Tubal Reversal Center perform over 800 tubal ligation reversal procedures each year. Patients travel here from across the United States and from around the world to have their tubes untied because of our high pregnancy success rates and the quality of our patient care.  We untie tubes and repair tubal blockage.

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