Thursday, November 11, 2010

Choosing The Most Experienced Tubal Reversal Doctor

Tubal Reversal Message Board Member, Rajsan04, comes to the board with questions and concerns about choosing a tubal reversal doctor with the most experience and financing her reverse tubal procedure. For the most successful tubal reversal surgery, it is important for the doctor to have performed at least 500 tubal reversals and that he or she is reversing tied tubes daily. Dr. Gary Berger has performed over 8000 tubal reversals and Dr. Monteith nearly 1000 reversal procedures. Experience is also an important indicator on whether reversal surgery will be performed if a woman has a difficult situation due to short tubes, missing tubal segments, fimbriectomy, or inherent diseases of the tubes. While most doctors would be unwilling – or unable - to perform a tubal reversal in one of these situations, Dr. Berger and Dr. Monteith are able to repair the tubes in 98% of cases, regardless of the type of sterilization that has been performed. Dr. Berger pioneered this technique for outpatient tubal reversal surgery and the procedure takes approximately an hour. Chapel Hill Tubal Reversal Center is a specialty clinic for tubal ligation reversal and Dr. Berger and Dr. Monteith are the only doctors in the US who limit their practice specifically to untying tied tubes. This experience has led to the most tubal reversal babies born worldwide.

Tubal Reversal Surgery or In Vitro Fertilization?

Is in-vitro fertilization or tubal reversal surgery better after tubes have been tied? Tubal Reversal Message Board Member writes about her experiences while considering IVF and sterilization reversal surgery. She is researching which of the two is the right choice to restore her fertility after her tubal ligation. Chapel Hill Tubal Reversal Center staff and other Tubal Reversal Message Board members offer their support and information. After researching her options, this member writes "We both feel very confident with Dr. Berger and his team." Dr. Berger and Dr. Monteith are the only doctors in the US who limit their practice specifically to tubal reversal surgery. Chapel Hill Tubal Reversal Center is a unique medical facility exclusively for tubal ligation reversal; helping couples from all over the world realize their dream of having children after a tubal sterilization. With their surgical reversal experience tubal reversal can be a better option than IVF for many couples seeking more children after a tubal ligation procedure.

Posted by rajsan04 (Member # 15108) on November 10, 2010 09:11 AM :
Hi, My name is Sandy and my husband and I have been married for 8 years and for the past few years we have been talking about having a baby. He has a daughter from a previous marriage and I have two sons from a previous marriage. We are both 39 and thought this would be the best time before its to late to get a tubal reversal and give it a try. I have my first appointment with an RE yesterday and I'm feeling very discouraged. I was assuming because this RE has many options for pregnancy, such as IVF , egg donation and tubal reversal, I was expecting him to be very supportive of our decision to have a tubal reversal and to have a child but he didn't sound like it! Before I had any examination he kept going on and on about my age and the risk of getting pregnant at my age. He was pushing me towards IVF (no way we could afford that) Luckily my health insurance covers the tubal reversal 100%, I am a state employee. I told him I'm aware of the risk but I would like to get the tubal. He didn't seem very happy about my decision and said, well lets exam you first..if I don't see many follicles or if they are in bad shape the tubal reversal wont even be an option! He seemed to be full of attitude the entire time and I felt a little uncomfortable to be honest. While my feet was up and ready to be examined, the doctor made the comment "Your kids are grown now, you are out of the woods finally, why would you want to do this all over again? I was completely floored, I couldn't believe I was hearing this coming from someone who was suppose to be encouraging my chances of having another child! I didn't know quite what to say, I just kind of chuckled at his comment and kept quiet. So he starts to exam me, and here comes the problems! He jumps because he sees a polyp on my cervix the size of a walnut, which he removes right away. There was some heavy bleeding after that which he got to stop after about 10 minutes. He gives me the pap smear and pelvic exam, breast exam, then gets me ready for the ultrasound of my ovary's and uterus. The good news is, and at his surprise, I have many healthy cyst and follicles on my left ovary and also saw that I was ovulating! Which I already knew because I test for a surge everyday with OPK. I know that is probably ridiculous since my tubes are tied but I just wanted to see if some of my parts are still working and get use to the idea of checking for it every month when I do get the reversal. When I told him I detected a surge that same day he seemed annoyed that I was even checking! Anyways, here comes another problem! My right ovary has good follicles, not as many as the left ovary but he saw a shadow of some mass inside my right ovary. He looked at me and said, well your just full of surprises aren't you? I was freaking out at this point of course! Come to find out I have a dermoid cyst in my right ovary, those weird ones that contain teeth and hair, sometimes eyes and bone fragments. After the exam and my husband and I are back in his office all of a sudden he seems to be more encouraging about the tubal reversal (because of the shape and amount of follicles I have) but is trying to decide if I should get my cyst removed and tubal at the same time or have 2 separate surgeries. Also, my husband and I had intercourse within a 12 hour period of my exam so he checked for any signs of sperm and not that I had enough bad news to work with, he tells me he didn't see any signs of sperm at ALL. He said there was a possibility the large polyp blocked it from getting to the point he had checked but he would need to get his semen checked before we go any further with anything. So he has an appt. to do that on Friday. Before leaving the doctor told me the tubal reversal surgery was not a walk in the park, I would practically be hanging upside down, blood rushing to my head for 4 hours and pressure put on my diaphragm, which wasn't good for me because I was over weight, so another thing, he suggest I lose at least 60 lbs before I have any surgery performed. I can lose the weight but just very discouraged about everything else, I was not happy when I left there, I was crying all the way home, my husband was driving feeling helpless for me, not sure what to say to me except everything was going to be okay. I get the results of the pap and polyp on Friday.

The reason I'm talking about all of this is because I'm so discouraged I feel like just giving up now. My husband and I want a child so much. I don't feel very encouraged to continue with all of this. I'm just not sure what to do. My husband wants to go all the way and try all our options. I wanted to try who seems to be very popular with tubal reversals, Dr. Berger in North Carolina, which is very close to me, I am in Virginia, but my insurance wont cover the expenses with him being in a different state, so I have no choice but to use this doctor. There are other RE's in Virginia but further away than he is but I'm willing to drive the distance if I have to. The RE I'm seeing right now has a good track record. He said his tubal reversals are successful but he is worried about the health of my eggs because of my age. I understand he is right in what he is saying but I wasn't very encouraging at all.

I know this is a lot to digest lol, just need some sort of advice here, not sure what to do, thanks!


Posted by NJgirlinWI (Member # 12872) on November 10, 2010 09:39 AM :
Hi Sandy, I hope you've had a chance to catch your breath after that difficult office visit. Your age is not a factor but your reproductive health is... I would see what this RE comes back with as far as test results and then contact CHTRC for their opinion. I don't know about other clinics but I was never "hanging upside down" for my TR surgery, LOL!
There is a weight requirement for the surgery, it is based on BMI and you can find the details on this website to see where you fall within the range.
I hope you are able to sort this all out and move ahead with your TR. I promise that the staff at CHTRC will help you every step of the way, they are terrific at what they do!!
Take care and keep us posted

Posted by Hopeful1970 (Member # 14190) on November 10, 2010 09:43 AM :
I wouldn't let him get to you. I am 40 at present and I am currently 31 week pregnant. I also had PTLS bad and had battled it for 19 years before having my TR done. I just can not begin to tell you how many uncaring doctors I have seen about the problems I was having before my TR. I had talked to a few doctors also about having a TR done before we made up our mind to have it done at CHTRC. If you have it it done I would go with CHTRC no matter the cost. That is their job every day and in my opinon they are the best at what they do. The last doctor that I had seen about having my TR done, before making the drive to NC. Told me that I would need to have a tubal implant done. Meaning that they would have to cut a hole in my uterus and putting the tube into that hole and stetch it in. I told this to Dr. M when he seen me the day of surgery. He told me not to worry and to let him figure that part out during surgery. When I woke up Dr. M said to me I did not need to do the implant and you have really good lengths on your tubes. When I had my surgery done last November. My DH was over seas. Two week after he came home. I got my first and only BFP for now. As I said I would go with the best right off the bat, no matter the cost. And please, please do not let the things that the RE said to you get to you. Most will always always try to push you to what will cost you the most money. Good luck, Sabrina OH yeah, by the way. Dr M didn't have me in surgery long enough to have me hanging up side down for 4 hours. I was in surgery maybe 1 hr and 15 mins before waking up in recovery. So you can chock that up as one lie that that doctor told you.

Posted by ismagirl (Member # 13074) on November 10, 2010 09:51 AM :
i had ivf 2 rounds first round my egg didn't form fully and second round i had 3 grade a embryo implanted and i had a miscarriage. your egg health is going to be the same with ivf or tubal with ivf they give you egg stimulating hormones and if needed after tr you can take clomid to increase your eggs. of course clomid cost 20 and ivf meds hundreds. tr surgery by dr at chapel hill are very easy to have and very easy to heal from so i would be scared to have a tr from a dr who is telling you that you will be hanging upside down blood rushing etc. tr surgery at chapel hill takes about an hour and there really isn't much pain involved. if you can afford to go to chapel hill you should. they take credit cards and have other payment options available. either way i hope everything goes well for you
oh yeh i am almost 37 and i have a 9month old daughter from tr now working on #2

Posted by eneitge (Member # 14887) on November 10, 2010 09:53 AM :
Sandy, sweetie, you had an awful experience and I sure feel for you! Maybe you and your husband can look at your finances and find a way for Dr. Berger or Dr. Monteith to do your surgery so you're with someone who is encouraging and helpful. And they don't hang you upside down for four hours either My surgery in June took a little over an hour I believe, and I don't think Dr. Berger had me bat-ways at any point If going to CHTRC and paying out of pocket isn't financially realistic, then please look into the other REs in your insurance coverage availability, this guy sounds like he is not the right person for you if you left feeling hopeless and your husband felt helpless to comfort you. Just my opinion, but you deserve someone who will give you realistic information AND encouragement. Get a second opinion, and a third, and fourth...find the right person for YOU no matter what the distance My husband and I are from WI, and we never questioned going the distance to NC for great care, this was the right fit for us. Good luck hun, hoping you find the right fit for you and your husband soon

Posted by strawberry (Member # 14961) on November 10, 2010 10:05 AM :
I'm sorry for the experience you had with that RE. I can tell you my surgery did not last 4 hrs. It was under 1hr. No surgery is a picnic so to speak but I did not have any problems. CHTRC took great care of me! They were the only ones I would consider for my TR and I have regrets! Please don't be discouraged!

Posted by rajsan04 (Member # 15108) on November 10, 2010 10:28 AM :
Thanks so much for your encouraging and supportive responses! I'm shocked that none of you were hanging upside down during the surgery lol. He told me several times during our meeting that I would be at an angle (not completely upside down) but enough of an angle that blood would be rushing to my head and pressure on my diaphragm. I forgot to mention that he said DEATH is always a factor in any surgery. I was like geezz! My husband and I can cover the cost for Dr. Berger, we can manage, just thought it was nice we wouldn't have to pay for it and we were lucky enough to have insurance to cover it 100%. But after that experience, I'm not the least bit worried about paying for it. I've wanted to see Dr. Berger or Dr. M before anyone and now I feel like they are the best for the job right now. But what about the Dermoid Cyst that has to be removed from my right ovary? Should I continue with this doctor to at least get the dermoid removed or find someone else to do it? I would like for my insurance company to at least cover the expenses of this surgery.

Posted by Julia, RN (Member # 10) on November 10, 2010 11:17 AM :
Dear Rajsan04: We frequently hear from potential patients that a local doctor performs reversals when, in fact, their expertise in in vitro fertilization (IVF). For tubal reversal surgery, it is important for the doctor to have performed at least 500 tubal reversals and that he or she performs this surgery daily. (Dr. Berger has performed over 8000 reversals and Dr. Monteith nearly 1000.) Experience is also an important indicator on whether surgery will be performed if a woman has a difficult situation due to short tubes, missing tubal segments, fimbriectomy, or inherent diseases of the tubes. While most doctors would be unwilling – or unable - to perform a reversal in one of these situations, Dr. Berger and Dr. Monteith are able to repair the tubes in 98% of cases, regardless of the type of sterilization that has been performed. Pregnancy rates for our patients in your age group average 64%. Dr. Berger pioneered this technique for outpatient tubal reversal surgery and the procedure takes approximately an hour. The majority of patients return to work in 3-5 days and are back to the majority of normal activities within 7 - 10 days. Compare this to the operating and recovery times in other facilities, with less experienced doctors, where surgery takes 3 - 4 hours and patients may spend 2 - 3 nights in the hospital and have a 6 week recovery. Dr. Berger and Dr. Monteith are the only doctors in the US who limit their practice specifically to tubal reversal surgery only. This means you will be with other women going through the same experience and will have a nurse and your doctor available 24/7 following surgery. I hope this is helpful. We do have a few appointments during November that are available at a discounted fee if you would like to contact me at JuliaS@tubal-reversal.net. Julia S., RN

Posted by prayingfor3 (Member # 14807) on November 10, 2010 11:38 AM :
Hi Sandy,
I am Heather(37) and live in Marion, Virginia. I had my TR surgery 5/12/10 much against dr advise also. I was told by 2 RE that I was too old and had too many abdominal surgeries 8 Before the tr!
Dr M did my surgery, and he said I was in better shape than he expexcted. As of today I am 10 weeks pregnant. It took only 4 ovulation cycles to conceive little bean. So far so good!
It is hard not to get discouraged but try not to. You do what you feel is best for you and your family. I do recommend CHTRC over any I looked into.
Oh, and if you dh SA is not as good as it should be, try Fertil- Aid ( get it from Babyhopes.com) My hubbys SA was pretty bad 10% motility..but after 6 months on it we were pregnant!!!
Don't give up hope and pray alot.
Baby dust to you and all trying!
Heather

Posted by rajsan04 (Member # 15108) on November 10, 2010 12:31 PM :
Heather, congrats on your pregnancy! Your story gives me much hope! Thank you for the baby dust and prays, I sure do need it!

Posted by Simonsen6 (Member # 10172) on November 10, 2010 02:59 PM :
Dear Rajsan04
WOW- ur appointment with the RE sounds a lot like how mine went and I too left there crying and feeling so discouraged... except I had already had my TR (by dr berger) before I went there but I was being seen by the RE because of a massive mass on my uterus that they found a month earlier when I had kidney stones... SO the Re is mad that ONE - I had the Tr done by someone else and when he found out it was Dr berger he became a total jerk to me and told me my odds where not good or ever conceiving and IVF would be my only hope. TWO- I have had endo my whole life and have had 7 surguries to remove it and this RE questioned if I had "really" ever had endo at all. I have all the symptoms and that was just too much of a red flag that I had been making it up my whole life... Told you he was a Jerk! Then he did the ultra sound and couldn't find the mass, there wasn't one to be found and refered to the Er dr's as stupid and didn't know what they were talking about... the exam he did he told me I was probably perimenopausal and just wasted all this money on a tr - where if I would have went with him he would have pointed me in the rigt direction instead of giving me false hope...
Left there crying - It had been 8 months since my TR and I had also already had an HSG to confirm my tubes were both open.. I emailed dr berger that night with questions and thngs this dr had told me... The funny thng was this RE had once applied for a job with Dr. Berger and I am SO SO SO glad Dr.Berger could see the type of guy this was and for what ever reasons this RE didn't get the job... I think that is why he was such a jerk to me once he found out I had had my Tr done by Dr. Berger. Dr Berger email me back with + thougts and things do and not to stress...... I became PG THAT cycle with my first TR baby!!!!! I am currently 27 1/2 weeks Pg with my second Tr baby.. Don't give up hope and DO NOT let this quack of an RE do your TR. Really you want the best go to Chapel Hill and have Dr. Berger or Dr. Monteith do your TR. This is what they do and teh only thing they do. Did you know for an extra $1,000 you have have them do a lap before the Tr - where they can take care and make sure everything looks good before the Tr? The day of My TR there was one Tr sister the day before that during her TR Dr. Berger noticed she had a hernia and took care of it, the day of my surgery there was another lady after me that also had something like that and he took care of that for her too... Chapel hill is teh only place I would go and know I am truley in good hands... As far as being 39 follow your heart and do whats best for you two... I say GO FOR IT...
DOn't lose faith nor hope!
Lots of Love
Becki

Posted by Julie B., RN (Member # 14875) on November 10, 2010 03:28 PM :
Hi, ladies. It is disheartening to hear that many of you have had what you consider "bad experiences" with various doctors. Health is extremely important, and we should all feel we can talk to and trust the doctors we depend on as a general rule. Of course, I can't speak to your specific situations since I was not there and don't know the doctors. But I can certainly vouch for Dr. Berger and Dr. Monteith , as well as for the nurses and staff members here at Chapel Hill Tubal Reversal Center. I am very proud to work in an establishment that puts patients first, and has so much emphasis on excellent care and patient safety. As you can see from other comments, the surgeons here are absolutely at the top of their field, and each surgeon does between 12 and 15 tubal reversal surgeries each week. Just to put your fears at rest, Rajsan04, nobody is ever "hanging upside down" during surgery with Dr. Berger or Dr. Monteith. The surgery is quick, there is very little blood loss, and patients recover quickly and are able to go rest in comfort at the hotel (rather than in a hospital). Rasjan04, please note that on the home page of this Web site there is a link that allows you to request a free DVD of Dr. Berger performing tubal reversal surgery. We encourage anybody who is considering TR and has questions about what happens during surgery to click the link and watch your video when it arrives. As you will see in the video, there certainly isn't any hanging upside down! I hope that helps ease any fears you have. Please, for all of you ladies, don't hesitate to keep sharing questions or concerns with us. We want to make your TR journey as smooth as possible. Julie B., RN

Posted by jacquelynwilliamseid (Member # 14943) on November 10, 2010 09:27 PM :
Hi Sandy my name is Jacque and I am very sorry to hear about the experience that you have had. I also had a very bad experience with RE and OB was told by RE that TR was not really and option for me due to 2 c-sections and having TL over 9 years ago. He told me that I would have too much scar tissue and it would not be very good idea to even consider it. He however was very willing to take my money for IVF . I also went to a OB in my area that does TR he told me that he would not do the surgery either that scar tissue would be too much and that it was a waste of time that I should have IVF. The thing is that me and my DH just wanted to have the oppurtunity to try to have a child on our own. The problem is that at every turn we felt shut down and like there was no hope. I sit here now having had my TR on September the 14th 2010. I will say this CHTRC gives back hope to thousands of women who have had their hope taken away from them. No one can tell you what is the right decision for you we can only tell you of the experience that we have all had and hope that this helps. Try not to give up or get discouraged. CHTRC has payment plans for saving up for the surgery. I was wondering if the doctor did a FSH test on you to tell you wether or not your eggs were good or not for all you know you could have more eggs than someone younger than you. Try not to give up hope and stay strong. Good luck to you in what ever decision that you choose and I hope that all goes well with you.

Jacque

Posted by rajsan04 (Member # 15108) on November 11, 2010 10:10 AM :
Thank you Jacque and all you ladies for sharing your experiences and encouraging words. My husband and I talked last night for hours. I shared with him your replies to my message and emails. We both feel very confident with Dr. Berger and his team. Plus we are only 3 hours away! I also talked with my insurance company and because they do cover the cost of the tubal 100% and we are PPO, that they will reimburse the cost after the TR is done. Which of course is nice, but after what we have been through with the local RE and after hearing your experiences and the encouragement from the staff with Dr. Berger and Dr. M, it wouldnt really matter if we were to be reimburse or not! I am excited and honor to become apart of this journey with the rest of you and to share the bond of wanting this dream to happen for all of us. I will be spending the next 3 to 4 months losing the weight I need to lose. If anything is a motivator, it is this for sure! I look forward to letting all of you know I'm in Chapel Hill and ready to get my TR! Until then you will be in my prayers and thoughts! Love, Sandy 


Source: http://www.tubal-reversal.net/forum-topic-tubal_reversal-1t003725.htm

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