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Is Pregnancy Possible Through Tubal Ligation Reversal?

Posted on Mon, 14 Dec 2015

Question: Hi, my name is xxxxxxxxxxx. I am 47 years old and would like to know if I can still get pregnant at this age. My husband is 35 years old and we both would like to have a child. I had my tubal reversal in November 2007 and until now 2015, I have been unsuccessful in getting pregnant. Is it because I have a low count in eggs or my sex hormones which is why I am unable to get pregnant? Do I need to take some kind of medication to help my hormones? Need your help and advise.

Answered by Dr. Pankaj Borade (46 minutes later)

Brief Answer:
Investigations required

Detailed Answer:

Dear,
Welcome to HCM
I have read your query.

my questions to you are:
1) Have you been pregnant before?
2) How are your cycles, regular, heavy, long, associated with pain?
3) how frequently have you been having sex?
4) do either of you smoke drink? use of lubricant while sex?
5) have you ever been treated for sexually transmitted disease in past?

Answers to these can provide some vital information at understanding background of your condition.

Well, for pregnancy one must release healthy eggs. The reproductive tract must allow an egg to pass into the fallopian tubes and allow the sperm to join the egg for fertilization. The fertilized egg must travel on to the uterus and implant in the lining. Tests for female infertility attempt to determine whether any of these processes are impaired.

In view of this, I may suggest you few investigation
1) regular gyneological exam.
2) specific test:
ovulation test- it can help us knowing if there is any impairment in process of ovulation
Considering a history of tubal ligation, it is important to check for the patency of Fallopian tubes. Hysterosalpingography can be suggested here.
For your partner semen analysis can be indicated.

These investigations can help us to find the problem and to know about ovarian reserve and about ovulation. Answers to your question lie in the result of these tests.

Additionally there could be other medical conditions that can cause infertility but the discussion of those is beyond the scope on this platform, and would require consulation to doctor in person.

kindly revert back with answers soon.
Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Pankaj Borade (14 hours later)

Thank you Dr. XXXXXXX Borade for your response. My answers to your questions are as follows -
1. Yes, I have been pregnant before with 4 children. I had tubal ligation in Feb 1997. Then had it reversed in Nov 2007 when I got married again.
2. My cycles are regular usually 4-5 days, but no pain
3. Sex is every other day
4. My husband and I don't smoke but he drinks a lot. We don't use lubricant during sex. My husband had a hernia operation in his early 20's.
5. No, I have not been treated for sexually transmitted diseases in the past

As per your suggestion, I would do a regular gyneological exam and ovulation test and for my husband to have a semen analysis.

Thank you and look forward to hearing from you again.

Answered by Dr. Pankaj Borade (2 hours later)

Brief Answer:
few investigations

Detailed Answer:
Thank you for the reply.
Your information is suggestive of normal ovarian functionality in past. A favorable indication.

I would suggest:
1) A hysterosalpinogram (HSG- fertility test for tubal patency and normalcy of the uterine cavity), to check the length and function of your remaining fallopian tubes. An HSG can be doing using XXXXXXX and X-ray or saline and air along with ultrasound.
2) A sperm count and semen analysis for a male partner to rule out any infertility problems.

Thanks for asking.
Regards.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Pankaj Borade (5 hours later)

Thank you again. I shall have these tests done and will advise you on the outcome.

Answered by Dr. Pankaj Borade (8 hours later)

Brief Answer:
Wish you a healthy life ahead!

Detailed Answer:
Welcome for further suggestion.
Wish you a healthy life ahead!

Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Pankaj Borade (18 days later)

Hi Doc, good to talk to you again. I have not got my period for the month of November yet. My first date of my last period was 12 October 2015. My stomach feels bloated, have been spitting a lot, trying to vomit but can't, mid to lower back ache. I did a home pregnancy test yesterday but negative. Is there something wrong with me? Please advise. Regards,

Answered by Dr. Pankaj Borade (3 days later)

Brief Answer:
an ultrasound examination

Detailed Answer:
Dear,
Thank you for asking. My apologies for the delay.
As i can see that your periods are long due and symptoms of nausea and stomach discomfort, considering which i would advice you to investigate for ruling out the possibility of pregnancy.
An ultrasound examination of uterus can help us in accurately determining the condition and status of uterus.
Repeat of pregnancy test can be considered, however are not very reliable.

I presume that there are no associated symptoms of fever, pain, and other complaints in case of which a physician consultation is warranted.

Therefore, an ultrasound test is highly recommended. In case if the discomfort is severe an immediate consultation to local doctor is advisable.

Welcome for further suggestions.

Regards,
Dr Pankaj Borade

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Above answer was peer-reviewed by : Dr. Arnab Banerjee