Q) What are the steps for a tubal reversal?
A) You must obtain the
post operative and pathology reports from the doctor who performed the tubal ligation or the hospital. These reports
are then sent to prospective doctors who perform tubal reversals for review. Once you have chosen a doctor that you
feel comfortable with, follow his/her advice. Sometimes the doctor will require the male to have a semen analysis before
performing the tubal reversal. This is to prevent the female from undergoing surgery if there is a problem with the
male until the problem is corrected.
Q) What type records do I
send to the prospective doctor?
A) Copies NOT ORIGINALS of
post operative and pathology reports from the tubal ligation and gynecology history if available.
Q) What kind of doctor do
I look for?
A) You want a doctor
who performs micro reproductive surgery. Ob/Gyn F.A.C.O.G or a Reproductive Endocrinologist.
Q) What tests should I expect
to have prior to tubal reversal?
A) The basic tests performed
include a pelvic exam, a check of basal body temperature (BBT) charts, and the monitoring of some baseline hormone levels,
such as prolactin and progesterone levels during the luteal phase. In addition, a postcoital test (PCT) or diagnostic
laparoscopy may be performed. Some doctors may require a complete CBC and hormone panel to rule out menopause.
Q) How long is the hospital
stay?
A) This depends upon
inpatient or outpatient surgery and your doctor. Most tubal reversals are performed outpatient and home within 24 hours.
Q) What is the recovery time
for a tubal reversal?
A) This depends upon
the patient's tolerance for pain and possibly unforeseen complications. Most women are fully recovered in 3-4 weeks.
Q) Does the procedure hurt?
A) Some women compare
the pain to that of a c-section and some experience little or no pain at all.
Q) How big is the incision?
A) Generally 3-5 inches
across the abdomen.
Q) How will the incision be
closed?
A) Normally staples,
stitches, surgical glue, or an adhesive are used to close the incision.
Q) What can I expect the incision
to look like?
A) The first time you
look, it may be red or pink in color. It may even appear to be puffy. As long as it isn't bleeding and you don't
have a fever, you should be fine.
Q) Is it normal for the incision
to become numb?
A) It is very normal.
Q) What can I expect my cycles
to be like after the tubal reversal?
A) Most women do not
see a change in their cycles from pre-TR to post-TR. Some women experience shorter and lighter cycles and vice versa.
Q) When can I return to work?
A) Generally within
one to two weeks when no heavy lifting is involved: otherwise expect 4-6 weeks.
Q) When can we begin trying
to conceive?
A) Some doctors say
as soon as you feel like it and others say wait 4-6 weeks. Ask the opinion of your doctor.
Q) Is it okay to become pregnant
the first or second month after the reversal?
A) Yes. There
is no relation between miscarriages and tubal reversals. Most miscarriages in tubal reversal women is due to a hormonal
deficiency.
Q) What should cervical mucus
look like?
A) Fertile mucus looks
like the white of an uncooked egg; it's clear and transparent. It is also elastic and stretches about 4 inches.
Nonfertile mucus is cloudy, sticky, and not stretchy.
Q) How do you chart basal
body temperature (BBT)?
A) Using a BBT thermometer,
take your temp orally, vaginally, or rectally (but the same through a cycle) first thing upon awakening, before any other
activity. Take the temp about the same time every day after 3 consecutive hours of sleep. Record the temp onto
your chart. (reference Taking Charge of Your Fertility by Toni Weschler pgs. 70-77)
Q) When should you begin temping?
A) It is a good idea
to chart you temp 3-6 months prior to the tubal reversal. This will give you a good indication of how your cycles work.
Q) When should we have our
first semen analysis (SA)?
A) If a semen analysis
wasn't done prior to the tubal reversal and after 3-6 months of trying to conceive and no pregnancy, then a semen analysis
should be done.
Q) When will we know the results
of the semen analysis (SA)?
A) Generally the
same day or the next. Make sure to ask for a copy of the results. This may come
in handy in the future.
Q) What if the results of
the semen analysis are not good?
A) Low sperm count-Vitamin
A and B will increase the count, more than one SA may be required to determine low count because a man's count fluctuates.
Low motility-
According to Sherman Sibler, there is nothing that can be done to increase motility.
Q) How do you tell the difference
between cervical mucus and semen?
A) Semen sometimes appears
to be rubbery and is thinner than cervical mucus, breaks easily, and dries quicker on your fingers. Also, cervical mucus
sinks in water and semen floats.
Q) What are OPK's?
A) Ovulation predictor
kits and are sometimes used to predict when ovulation will occur.
Q) How do you check cervical
position (CP)?
A) The most effective
position in which to check is squatting. Insert your middle finger and observe the following conditions: height, softness,
opening, wetness. (reference Taking Charge of Your Fertility by Toni Weschler pgs. 86-88)
Q) What is the cervical position
when ovulation occurs?
A) The cervix position
should be high, open and soft.
Q) What is the normal length
of the fallopian tubes before a tubal ligation?
A) 10-12 centimeters
(some women may have longer or shorter tubes)
Q) What is the length of tube
needed to conceive?
A) Most doctors say
at least 4cm, but there have been successful full term pregnancies with less.
Q) What is clomid used for?
A) It is used to stimulate
the pituitary gland to release more LH and FSH, and thus increases the stimulation of the ovary to produce an egg.
Q) What is baby aspirin used
for?
A) Aspirin can be used
as a simple treatment for repeat miscarriages related to autoantibodies.
This information is not intended
to be used as medical advice.
Use only as a reference.
References
Taking Charge of Your Fertility by
Toni Weschler
The Couples Guide to Fertility by
Dr. Gary Berger
Copyright 2000-2007 © Tammy Klueger
and Maggie Cole
