I want to get pregnant again but my doctor cut my fallopian tubes i have three kids and i had all of them by c-section but i want to get pregnant again but my doctor cut my fallopian tubes and i want to know if their is a way or a procedure i can fallow t

Dr. : Dr. Opsahl's answer is complete and truthful. I have a different opinion though. I question whether surgical repair of the fallopian tubes really has a place in a case like yours in 2011. In vitro fertiliztion is less invasive, has less uncertainty and less surgical risk . The cost is similar.

There : There are many issues to consider before making your decision to go forward with tubal reversal surgery or to undergo in vitro fertilization (ivf). This discussion will give you the information you need to make an informed decision regarding surgery versus ivf. • reversibility: many tubal ligations are reversible, but only if one area of the fallopian tube is occluded or destroyed by clip or burn techniques. If multiple areas have been treated, tubal ligation reversal is not a surgical option. • type of tubal ligation: it is very important for you to get the operative report to see which type of surgery was performed and the extent of tubal damage. For example, fallope ring or pomeroy tubal ligations can often be reversed if only one area of the tube has been treated. • insurance: even if you have an insurance policy that “covers infertility”, the vast majority will not cover tubal ligation reversal. However, if you have the surgery and it fails, after one year you may often have insurance coverage for in vitro fertilization. • costs: ivf with dr laurence jacobs at fertility centers of illinois (both chicago area ivf centers - highland park & river north) is approximately $11-12, 000. However, several ivf centers charge as much as $13, 000-$20, 000 per attempt. Laparotomy (regular incision) will cost approximately $25, 000-$30, 000 because it includes 2-3 days of hospitalization as well as the surgical and anesthesia bills. Laparoscopic tubal ligation reversal, which can be accomplished by a handful of skilled surgeons, generally will run $10, 000-$13, 000 since it can be performed as an out-patient procedure. • age of the female patient: women under 35 (usually with good egg/oocyte quality) can do either tubal ligation reversal surgery or in vitro fertilization (ivf) and expect a good outcome. However, women over 35 (with fair to poor egg/oocyte quality) may do better with ivf so that the best appearing and healthiest eggs can be chosen. The “ovarian reserve” of eggs can easily be assessed by doing a single blood test and an ultrasound on day 2, 3 or 4 of the menstrual cycle. (see the ‘ovarian reserve’ article on dr. Laurence jacobs’ website). • male factor: a thorough semen analysis (sa)–including ‘strict morphology’ should be done before a decision is made regarding surgery reversal versus ivf. If there is any significant male factor problem, ivf is the best choice since the best sperm can be utilized with ivf/icsi (intracytoplasmic sperm injection) at both of our fertility ivf centers in illinois in order to overcome male factor. • surgical treatment: most true infertility specialists (reproductive endocrinologists) in the chicago area will do an exploratory laparotomy with a large incision to do reversal surgery. This involves three to four hours of surgery and two to three days of hospitalization. A few chicago area reproductive endocrinologists can do tubal ligation reversal surgery by laparoscopy as an out-patient, usually costing far less and taking less time. • will you need fertility therapy after a tubal ligation reversal? If you are young and there is no male factor problem, trying on your own for six months to a year is reasonable. If, however, you are over 35, or there is mild male factor, ovulation induction with IUI may still be necessary in order to get pregnant.

Absolutely, : Absolutely, if you are fertile, ivf can be performed.Your doctor can check an amh test to assess your fertility.

You : You have 2 basic options for achieving another pregnancy: surgical sterilization reversal and in vitro fertilization (ivf). You need to seek care from a reproductive surgeon or reproductive endocrinologist to determine the best option for you. Your dr. Will need to know the specific technique used to cut your fallopian tubes (ideally they would like to review the operation report), your general health and some reproductive fertility assessment tests. Sterilization reversal is one of the few reproductive surgeries that offers a high success rate. The surgery requires an operative microscope in order to remove the scar tissue around the ends of the tube that was cut and to sew them together. Not every surgeon is trained to perform microsurgery therefore you should seek out a surgeon with experience. Ivf does not require that your fallopian tubes be open. Ivf is a good option for situations in which the sterilization surgery removed a large amount of fallopian tube, the woman's age is older than 35-38 years or or there is also a male factor involved such that the sperm has a low potential for fertilizing the egg. You did not state in your question whether this is the same partner that created the first 3 children or whether you may have a new partner and he may or may not be fertile. In order to choose between these 2 treatment options, we need to determine that there would be sufficient to that the end of the sterilization reversal to yield a high probability of success compared to ivf, that your fertility potential is not compromised suggesting a small window of opportunity to achieve pregnancy, that your husband has normally functioning sperm and it you are willing to investigate at least one year after surgery to achieve pregnancy. Additionally, if you're a good surgical candidate and you want to have multiple children then surgery may be a better option because we cannot always guarantee that you will have extra embryos frozen after ivf. We often cannot reliably determine whether surgery or ivf would be the best option. We also need to look at the costs of both surgery and ivf with respect to the absolute costs and what insurance will pay for. Sterilization reversal surgery can cost almost as much as in ivf cycle because the surgery requires anywhere from 2-4 hours to perform in the operating room is very expensive part of the hospital. In conclusion, you probably have 2 good options for achieving another child. I predict that when you meet with your physician, at the answer to some of these questions will become more obvious. Good luck.

Possible: Success of a tubal reversal depends on three things: age of the patient and at 20 you are in great shape, skill of the surgeon and length of tubal segments remaining. In my experience, the "bands" are the easiest to reverse and give you the best success rates. Ivf is also an option but generally is more expensive. It is a choice. Good luck.

Very difficult: There really are only a couple of options. You first need to see an infertility physician. They might due a test to see if you have enough remaining fallopian tube to have a surgical procedure to "put your tubes back together." this is usually a very expensive major surgery, generally not covered by insurance. The alternative is ivf, also expensive, but possibly covered at least partially by ins.