The Story of Tubal Reversal Surgery in the United States
When our surgeons trained in Obstetrics and Gynecology, tubal reversal surgeries were relatively common. This is for two reasons:
1. IUDs were not popular, so there were a lot of people having tubal sterilization
2. In vitro fertilization technique was still being perfected, so success rates were fairly low
Since there were a lot of people having tubal sterilization, and for every five people who had sterilization 1-2 go on to regret that decision for one reason or another, there was a lot of demand for reversal procedures. At the same time, lacking widespread IVF success, tubal reversal was a fairly popular way to get around a previous sterilization procedure and have another child.
At the same time, in those days reproductive endocrinologists tended to be expert reproductive surgeons, and almost anyone with a reproductive endocrinology credential was also highly qualified to perform a tubal sterilization reversal. So we had a situation of fairly high demand, but also plenty of supply of surgeons who could do the procedure, and needs were met.
Fast forward 20 years, and things have changed. With the huge upswing in long acting reversible contraception, fewer women are having tubal ligation than 20 years previously. And with the massive success of in vitro fertilization as a viable way to achieve pregnancy in the face of almost any fertility barrier, reproductive endocrinology as a field has moved away from surgery as a method to achieve pregnancy and moved towards high volume IVF as a medical practice. This is because IVF is not only quite successful, but also in high volume practice is a lucrative practice for the IVF physicians, embryologists, and embryology lab owners. On both of these fronts, tubal reversal procedures have become less common.
20 years ago if a patient who had been surgically sterilized desired a pregnancy, reversal would be highly considered. But today, if the same patient consults with a relatively non-surgical reproductive endocrinologist, most likely IVF will be the recommendation. The reality is that we recommend what we can do, so if REI physicians are no longer being trained to do tubal reversals, they are less likely to recommend them even to good candidates.
Can this trend be reversed? Yes! But we will not reverse the trend by turning reproductive endocrinologists back into the expert surgeons they were in the past. Instead, it is the minimally invasive surgery experts that take up the mantle they left behind.
At Tubal Reversal Northwest, we combine nationally expert minimally invasive surgeons with a desire to offer cutting edge microsurgery techniques to the women of the Pacific Northwest. Through the use of laparoscopic techniques and our beautiful outpatient surgery center, we can reverse tubal sterilization as an outpatient procedure at a lower cost than in vitro fertilization.
If you are considering restoring fertility through tubal reversal surgery, give us a call for a free records review and phone consultation. Tubal Reversal Northwest serves patients from Portland, Oregon, California, Washington, and from throughout the Pacific Northwest.
Tubal Reversal Northwest
Portland, OR