Ask the Doctor-April 2003

Question:
I have had my tubes tied in the past. Can I have artificial insemination to get pregnant?

Answer:
No you cannot get pregnant with inseminations after you have had your tubes tied. The reason is inseminations will not allow you to conceive is the conduit that allows the sperm and egg to meet, the tube, has been interrupted. You will need one of the following done: 1) IVF or 2) tubal reversal.

IVF -- i.e., the 'test tube' baby program bypasses the fallopian tubes and places the embryo directly into the uterus. Tubal reversal -- i.e., getting your tubes 'untied' reopens the tube and allows the sperm and egg to come into contact as if the tubes were never tied.

Both treatments have terrific success rates, but you may be a candidate for one but not the other. Ask the doctors at the Florida Fertility Institute which treatment is best for you.

Question:
If I have IVF, am I going to have a multiple pregnancy with 5 or 6 babies like you see on TV?

Answer:
In vitro fertilization or IVF is the process by which eggs are retrieved from a woman's ovaries, fertilized with a man's sperm and the resulting embryos are replaced into the uterus. Many factors go into determining the number of embryos to replace at the time of embryo transfer. Some of these factors are age, diagnosis, and embryo quality. However, generally speaking the number of embryos replaced is usually between two and four. With two to four embryos transferred, the chances of twins is approximately 20% and triples is less than 5%.

Question:
What is the success of tubal reversal?

Answer:
The success of tubal reversal is dependent upon several factors: the type of tubal ligation, the age of the woman, and the qualifications of the surgeon. The highest pregnancy rates occur among women whose sterilization operation was performed by Hulka clips, Fallope rings, omeroy ligation or single site bipolar coagulation, and is related to the length of normal tube following reparative surgery. Following the age of thirty-five, there is an overall decrease of fertility. Finally, the training and expertise of the surgeon is vitally important. Studies show that with proper microsurgical technique that the tubes are open 90% of the time and that greater than 70% of women get pregnant.