Sterilization is the most common contraceptive method utilized by couples in the United States. Approximately 27% of fertile women choose tubal sterilization as their method of contraception. About half of these surgeries are performed within 48 hours post-partum and the other half as interval procedures remote from a pregnancy. The procedures are meant to be permanent and most women enter into the decision with a sincere intention to prevent additional pregnancies.
But life is full of surprises. Circumstances change, relationships change, and family-building goals may change accordingly. Despite having consented to permanent sterilization, up to 14.3 % of sterilized women request information regarding fertility options within 14 years of the procedure. What are the options for couples who desire pregnancy following tubal sterilization?
The answer to that question is as varied as the couples asking it. Many factors may influence the decision-making process. Generally speaking, the categorical options are either surgery to reverse the sterilization (tubal reversal) or in vitro fertilization (IVF). Which process is the least expensive? Which is the easiest and least risky? Which is the best choice based on female age? Most importantly, which is the most likely to result in a successful conception?
Many factors influence the answers to these questions and often engender yet more questions. How old are both intended parents? How many more children does she want to have? Is the couple concerned about effective contraception after a successful pregnancy? Are there other fertility problems for either or both partners? Since most women considering having more children after choosing sterilization are older by the time they change their minds, in vitro fertilization is often the better recommendation since the chance of success are often much higher with this technique. However, for a significant number of women, tubal reversal remains a very valid – and relatively cost-effective – option.
The decision between IVF and tubal reversal is highly complex and profoundly affected by the factors of age, cost, and time as well as the presence of other potential fertility problems. If you are thinking about adding to your family, call our office to schedule a consultation to discuss your individual case and circumstances.