Although reversal surgery at Chapel Hill Tubal Reversal Center is statistically and financially the best option for pregnancy after a tubal ligation, women over age 40 have a special set of circumstances that are - unfortunately - often not addressed during an IVF consultation. The truth is, most IVF clinics will not accept patients over age 40 or 42 unless they agree to use donor eggs (eggs from a younger woman). This is to help keep their statistics high. We performed IVF for many years at Chapel Hill Tubal Reversal Center and Dr. Berger is now limiting his practice to tubal reversal surgery for a reason: It gives women who have previously had a sterilization the chance to conceive naturally again -- without medications, shots, and continued expense each time they want to conceive. Most of the women who contact us have already considered IVF - and have definitely ruled out donor egg IVF -and for good reason. It will be very important to ask your reproductive specialist very directly whether he/she will accept a woman age 42 for IVF without donor eggs or decline you if your FSH level is slightly elevated (as many clinics do).
For almost all women, reversal surgery is the most successful and least expensive option to have a baby after a previous tubal ligation.
Posted by Mslisalisaf (Member # 11583) on October 07, 2007 01:01 PM:
Hi, I am new to the message board, and I am still not sure if I want TR because I am 41 years old. I want the procedure that will give me the highest possible result of pregnancy. Please give me some insight on what you think.
Unsure Lisa
Posted by Cjl (Member # 11408) on October 07, 2007 01:48 PM:
Hi Lisa,
I am 42 and just had my TR done on 9/28/07. I choose do to the TR for several reasons. First I did the 3 day FSH, LH and Estradiol testing to see if having another baby was even in range for me. My FSH came back 5.1, my LH came back 3.8 and my Estradiol came back at 39. All are excellent. So from there, I went to see a Fertility specialist, who told me that I do still have eggs, but they don't know which eggs are good and which eggs are bad. So if I chose the IVF they would extract as many as they could, for about 18K, but that doesn't mean the eggs they extract would be good, but all the things to do along the way, shots etc to get there and not even know if it will work for 18K, was a little to risky for me. But the TR gives me a chance to try every month, possibly trying a few other medications to make the TR work for much less maoney. So for me the TR was the right choice. $5900 out of pocket, and several changes to keep trying...
Carla 42 TR 9/28/07
Posted by TheMzD (Member # 6500) on October 08, 2007 01:44 AM:
Lisa, welcome to the board. THis is a tough decision to have to make.
I agree with what Carla posted - have your doctor do the prelim. fertility workup on day 3 of your cycle (its OK if you are still bleeding). Get the FSH level checked (this is like the gas pedal that gets the ovaries working), LH and estradiol (high estradiol can mask high FSH). These levels will give you some idea of how to proceed.
A good FSH is a good indicator that you still have eggs left - your body isnt having to work too hard to get follicles started. BUT - keep in mind that our eggs are as old as we are. Having a lot left at this point doesnt mean they are any good. IVF can not guarantee a pregnancy, and is quite a bit more expensive for each attempt.
In fact, at our ages - I'm 41 today - IVF has pretty low odds for the expense.
Good luck as you make your choice!
Kay
Posted by Luckypj's (Member # 9974) on October 08, 2007 12:57 PM:
Lisa,
I will tell you my experience. I was told I was a perfect candidate for IVF. I had the FSH and all the prelims done. After my first round of IVF I became pregnant with twins, I lost both by 12 weeks and had to have a D & C. After much thought we decided on 1 more cycle that was unsuccessful. IVF is emotionally, physically, and financially draining. After my 2nd cycle the RE told me I was too old (I was 37) and so were my eggs and that I would probably need an egg donar. Thank goodness I found Dr. Berger! I had my TR in Dec of 06 and found out I was PG in February! I am due to deliver any day now! I know that IVF has worked for many but you should definitely do some soul searching before you plunge in. With IVF you only have the opportunity to conceive a couple of times a year and then you have to pay for it every time. With a reversal you can try to conceive once a month. I also believe that with IVF there is too much human interference. Natural is always better for your body! I thank God everyday for giving Dr. Berger the skill and the compassion to help out all of us who regret their TL. Sorry this is so lengthy! Whichever you choose I wish you much success and will remember you in my prayers!
Posted by nshelia7 (Member # 11224) on October 10, 2007 11:25 AM:
Hi Lisa I just wanted to chime and say that I agree with all the post you have received. I had my TR June 2007 and I am in the 2WW now.
I had 4 cycles of IVF two were successful,but 1 ended in M/C and the other ended right after the procedure. The other two were stopped because I was not responding. Luckpjs is correct that it is draining. My fertility Dr made me believe IVF was my only option. I have been on the IVF road since 2003. I feel like I have wasted a lot of money and hundreds,possibly thousands of viable eggs. IVF is extremely expensive. I can honestly say not including insurance payments we have spent over 50 grand. For the price of one of my prescription I could have had TR surgery twice. Do the math. The TR will give you the oppurtunity to try month after month as opposed to waiting to complete an IVF cycle. Just remember there are no guarantees with IVF even when the eggs are transferred they is no guarantee a pregnancy will happen. Talk to your DH and make a joint decision. God bless you and good luck in whatever decision you make.
Posted by nshelia7 (Member # 11224) on October 10, 2007 11:49 AM:
One other thing I did not mention those shots can be pretty painful OUCH Will you administer your own shots or will your DH have to? And if so have either of you given shots before? Its not an easy thing. My DH gave me my shots and sometimes I felt as if he were sticking me too hard, but I think i was just being paranoid and stressed. You will alos have to have vaginal ultrasounds, a battery of test
and your DH will have to his semen analyzed. Will your insurance cover this?
Just thought I would add that in , I found out about a lot of the additional charges after the fact.
Shelia
Posted by chrissybear (Member # 10248) on October 10, 2007 03:40 PM:
Hi Lisa, I had tried IVF last year around time and it is very emotionally and finaicaly draining. I wish I would have had my TR done 1st. To go though the process of IVF not having it work is the worst experience I ever had. I had my TR in May 2007 no BFP yet, but aleast we can try every and not a one or two time deal.
Good luck
Chrissy
TR 05/21/07
Posted by berta8133 (Member # 11188) on October 10, 2007 05:13 PM:
Lisa..I'm 37 (38 in a few weeks)...I went thru IVF in 05...'perfect' candidate..no reason it shouldn't take on first try.... well didn't work and all that $$ gone on one shot. After many DR's telling me TR was not option...DR B did the TR this year...7/23/07, I came out with lengths of 3cm on each side. We were blessed with a BFP 9/12/07 (first cycle TTC), sadly though ended as Ectopic 9/25/07. Even with the ectopic we are estatic to know we did get PG......and have another chance and another chance. Spending $6000 for chance after chance compared to easily $15-$17,000 one chance IVF...I'd go for the TR -- hands down.
I also have a friend that did IVF too-- a couple of cycles - no success...had her TR 10/06 and is expecting baby any day now...and Dr B did her TR as well...and she is 40.
Good luck to you with whatever decision you make.
Berta
TR 7/23/07
Ectopic 9/25/07
Posted by berta8133 (Member # 11188) on October 13, 2007 09:22 AM:
I'm sorry you feel that way Jerseygirl...however it is everyone's opinion....and we are all speaking from experience. Having tried IVF and it didn't work...then doing TR and having the CHANCE to do a repeat month after month is better than having the chance to do nothing because of financial reasons and insurance not covering IVF. I know there are women on the boards that have been sucessful with IVF..however statistics on that one too...the rate of it working first time....of ALL women that choose it...it is low.
Blocked tubes - everyone knows is a risk we take with TR... everything is a risk. I'm very sorry yours are blocked....but the chance was there for you, just as it would have been had you went with IVF first time. Bad hand dealt to you and once again very very sorry for you.
It doesn't matter if those that have posted have yet carried a baby to term....
Bottom line...everything happens for a reason. If we are meant to have a baby then we will..if not...then we wont regardless of the medical intervention used to try......
Not meaning to ruffle feathers..just expressing my opinion.
Posted by berta8133 (Member # 11188) on October 13, 2007 10:23 AM:
Tarebear...
I REALLY think you hit the nail on the head...with saying all should be tested / checked over prior to TR or IVF....this a valid and smart point..that really I'm sure alot of sisters just thought they could have the surgery and all would be great...not knowing the underlying problems.
I'm sorry for your situation as well. Good luck with your dr appt next week!!!
Berta
Posted by Tarebear38 (Member # 9544) on October 13, 2007 10:27 AM:
Thank you Berta! (I was editing while you were responding).
Posted by Mslisalisaf (Member # 11583) on October 13, 2007 01:12 PM:
Thank you ladies for all of the advice and personal histories with TR and IVF. Because of your insightful information I am going to have a battery of test and weigh my options. With prayer I know I will be strong no matter what the outcome. Thanks again ladies!
Posted by Tarebear38 (Member # 9544) on October 13, 2007 01:58 PM:
Good luck to you!
Posted by berta8133 (Member # 11188) on October 14, 2007 09:31 AM:
Mslisalisaf
Good luck to you on this journey!!
Berta
Posted by marly (Member # 9980) on October 16, 2007 06:46 PM:
hi All,
im considering reversal soon, but after having
4 c-sections in the past, would i have scar tissue? i was never told about this, and will it effect the surgery and it,s result,s. have had 4 goes at IVF with no success.
thanks marly x
Posted by Tarebear38 (Member # 9544) on October 16, 2007 11:37 PM:
Marly, I would definitely think about getting checked to see if you have any scar tissue or any other "plumbing" problem that could be preventing you from getting a sticky bean after all those IVF attemps. Good luck to you!
Posted by Julia Smith, RN (Member # 10) on November 22, 2007 11:40 PM:
Hi, Lisa. Although reversal surgery is statistically and financially the best option for pregnancy after a tubal ligation, women over age 40 have a special set of circumstances that are - unfortunately - often not addressed during an IVF consultation. The truth is, most IVF clinics will not accept patients over age 40 or 42 unless they agree to use donor eggs (eggs from a younger woman). This is to help keep their statistics high. We performed IVF for many years at our office and Dr. Berger is now limiting his practice to tubal reversal surgery for a reason: It gives women who have previously had a sterilization the chance to conceive naturally again -- without medications, shots, and continued expense each time they want to conceive. Most of the women who contact us have already considered IVF - and have definitely ruled out donor egg IVF - and for good reason.
It will be very important to ask your reproductive specialist very directly whether he/she will accept a woman age 42 for IVF without donor eggs or decline you if your FSH level is slightly elevated (as many clinics do).
For almost all women, reversal surgery is the most successful and least expensive option to have a baby after a previous tubal ligation.
I hope this is helpful.
Julia Smith RN
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