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How to concieve after a Tubal Ligation?

Mar 2013
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Practicing since : 1998
Answered : 5625 Questions
Hello, I am 38 years old and want to have another child, I currently have 2, and my oldest is 22, I had her when I was only 15. I guess Ive been bitten by the prego but bc I hav e the overwhelming desire to be pregnant again. Problem ... my tubes are tied and my husband is "snipped" ... what are our options
Posted Mon, 17 Feb 2014 in Getting Pregnant
Answered by Dr. Aarti Abraham 18 minutes later
Brief Answer: CHOICES DETAILED BELOW Detailed Answer: Hello XXXXXXX Thanks for writing to us with your health concern. Frankly speaking, let me put some statistics across. For you to be able to conceive again, you and your husband would both have to have a tubectomy reversal and a vasectomy reversal, respectively. Now, success rates after a tubal reversal range from 20 % to 70 %, with a lot depending on the age of the woman, prior surgery etc. At 38, as it is, the natural capacity of the ovaries to produce mature eggs declines tremendously ( this is called the ovarian reserve in scientific terms ). Vasectomy reversal rates too range from 20 % to 50 %. So now for your options - 1. You both decide to go for the reversal surgery, and try to conceive spontaneously. For doing this, prior assessment of your ovarian reserve is a must. This is done best by measuring the level of AMH and the number of baseline follicles on day 2 in your ovaries ( antral follicular count ). If the ovarian reserve is estimated to be good, you then opt for both the surgeries, and try naturally for a few months ( not more, considering your age ) and then go for ART ( assisted reproductive techniques ) to boost your chances. 2. You opt for a surrogate - your husbands sperm can be retrieved by testicular aspiration, and your eggs can be harvested ( again assuming you have good ovarian reserve ) and then a surrogate is chosen for IVF ( in vitro fertilization ). 3. Least invasive and best - adoption. All the best. Please feel free to discuss further.
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Follow-up: How to concieve after a Tubal Ligation? 17 minutes later
Thank you for getting back to me so timely, I really appreciate that. Neither of us are wanting a reversal, what we wanted to know could we take his sperm and my agg and plant it into my uterous?
Answered by Dr. Aarti Abraham 30 minutes later
Brief Answer: DETAILED BELOW Detailed Answer: Thank you for the appreciation. Yes of course, that is the first option I should have mentioned, only I assumed you would have considered it. Again the question of ovarian reserve is central to it. You should first have an assessment of your egg capacity. Next, a testicular biopsy will reveal if your husband has good sperm motility and count, as sometimes the motility and count are affected by vasectomy ( duct occlusion ). If these two parameters are fine, there is nothing that stops you from attempts at IVF - in vitro fertilization . Eggs would be retrieved from you, his sperm would be used, but fertilization would be outside the body and then the embryo would be transferred to your uterus. That is IVF and has at best 30 - 40 % success rate.
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