Tubal Reversal vs. IVF: Which is More Successful?

29 May
Ask Dr. Sher A Question

What is better IVF vs. tubal reversal

This is a question I get quite often. In my opinion, a more useful question is: “Which is more efficient?” let me first say that there is a relatively high birth rate following tubal ligation reversal (reanastomosis) when viewing a long term time horizon. In successful surgeries, the birth rate within 3 years of the procedure is approximately 50%. By comparison, when IVF performed in a center of excellence, the birth rate is comparable following a single attempt and is far less invasive than surgery. And unlike tubal reversal, IVF does not require hospitalization or an extended recovery period. Moreover, by doing IVF and leaving the tubal ligation undisturbed, the woman retains subsequent control over family planning without having to resort to using some other form of contraception.

Another point to be considered is the high incidence of tubal or ectopic pregnancy following the performance of tubal reversal (about 20%). Major surgery also requires a few days of hospitalization and subsequently a few weeks of convalescence. There is also a risk of post-operative complications, increased cost, time away from work, incapacitation, and significantly greater discomfort. The cost of a full cycle of IVF is, in fact, comparable to that of tubal reversal surgery.

In my opinion, provided that IVF is performed in a program with high success rates, tubal surgery for fixing damaged or blocked Fallopian tubes, with few exceptions, can no longer be justified financially or ethically.


  • jeff says:

    We just found out that our insurance will not cover IVF because my wife had tubal litigation 6 years ago. I had already did two semen analysis and my wife was taking birth control. we asked the doctors office to check with our insurance before we started the process but I guess nobody did till this week. We were told we were great candidates for micro IVF 2 months ago, last week we were advised that micro IVF was not an option. Financial manager states that only option is paying cash, my questions is whether to pursue TR since it is much cheaper and we are really frustrated with the miscommunication from the doctors office.

    • Geoffrey Sher says:

      There is no way that tubal reversal is less expensive than Micro-IVF. besides, the success rate per month of trying post a successful reversal is about 15 times lower and if pregnancy does occur post-TR the ectopic (tubal pregnancy) rate is 10m times greater than post-IVF.

      Please go to the home page of IVFauthority.com. When you get there look for a “search bar” in the upper right hand column. Then type in the following subjects into the bar, click and this will take you to all the relevant articles I posted there.
      1. “An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)

      2. Ovarian Stimulation for IVF: The most important determinant of IVF Outcome” (Nov. 2103)

      3. “Agonist/Antagonist Conversion Protocol”

      4. “Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)

      5.“A personalized, stepwise approach to IVF “ (Parts 1 & 2 (posted March, 2012)

      6. “IVF success: Factors that influence outcome”

      7. “Use of the Birth Control Pill in IVF”

      8.”TUbal ligation reversal versus IVF”

      9. “Micro-ivf”

      Consider calling 800-780-7437 or 702-699-7437 to arrange a Skype with me so we can discuss your case in detail.

      Finally, perhaps you would be interested in accessing my new book (recently released). It is the 4th edition (and a re-write) of “In Vitro Fertilization: The ART of Making Babies”. The book is available through “Amazon.com” as a down-load or in book form. It can also be obtained from most bookstores.

      Geoff Sher

      P.S: Please go to http://www.youtube.com/watch?v=Vp3GYuqn2eM&feature=youtu.be
      To view a video-tutorial by Linda Vignapiano RN, Clinical Manager at SIRM-Las Vegas.

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