Tubal Reversal: Versus IVF
Tubal Reversal is an outpatient surgery performed under general anesthesia through a small bikini incision. The tubes are reconstructed using microsurgery in a one to two hour procedure. The risk of the procedure is minimal and most patients can return to work five to seven days following the surgery.
In vitro fertilization (IVF) is otherwise known as 'test tube baby,' and has helped infertile couples conceive and bear children for over two decades. These days fertilization actually occurs in a dish, and not a test tube. It was originally developed to help couples overcome tubal factor infertility such as tubal ligation, but has become useful in treating other factors, such as immunological problems, unexplained infertility, and male factor infertility.
IVF is basically a four-step process. First, you take medications to make multiple follicles (eggs) begin to develop on your ovaries. This step is referred to as ovarian stimulation, or superovulation. Step two involves monitoring follicular growth by ultrasound, to determine egg growth and uterine lining development. When it is determined that the follicles and the uterine lining are appropriately mature, a trigger injection of Human Chorionic Gonadotropin is then administered.
Thirty-six hours later, the third step begins with retrieval of the eggs by ultrasound-guided-needle aspiration, an in-office procedure. A sperm specimen is then washed and prepared for insemination. The washed sperm is then placed in a dish with the eggs, and they are placed in an incubator for 18 hours. After 18 hours, the embryos are observed for normal fertilization. They are then incubated for further development into multi-cell embryos.
The fourth and final step involves transferring the embryos into the uterine cavity via a tube inserted through the cervix. The number transferred varies with the desires of the patient. Additional embryos may be frozen and stored for future use.
Tubal Reversal vs. IVF Comparison
|
Tubal Reversal |
IVF |
|
|
|
| 1. Cost |
$5,900-$6,900 |
$10,000 - $20,000 |
| 2. Medications |
No |
Yes |
| 3. Multiple Pregnancy |
No |
Yes |
| 4. Ectopic Pregnancy |
Yes |
Yes |
| 5. Additional Children |
Yes |
No |
| 6. Ethical Dilemmas |
No |
Yes |
| 7. Success |
70% |
30% per cycle |
| 8. Length Procedure |
1-2 hours |
Several Weeks |
Detailed Explanations:
- The cost of tubal reversal surgery at the Tubal Reversal Experts is $6,900 or reduced to $5,900 if paid at time of scheduling the surgery. Each attempt at IVF costs from $10,000 to $20,000 depending upon the center performing the procedure.
- IVF requires subcutaneous and intramuscular injections for a period of four to six weeks. The risk of the medication may include ovarian hyperstimulation syndrome and allergic reaction. There is controversy on whether these medications may be associated with an increased risk of developing ovarian cancer.
- There is no increased risk of having a multiple pregnancy following successful tubal reversal surgery. However, the risk of twins following IVF is approximately 30% and that of triplets or more is 5%.
- There is a 5-10% risk of a tubal pregnancy following tubal reversal surgery and a 1% risk following IVF.
- Following successful tubal reversal surgery, a woman can have additional children at no additional expense. Following successful IVF, additional children require additional IVF cycles.
- Ethical and religious dilemmas are considerable with IVF. These may include doing IVF itself, the disposal of excess fresh or cryopreserved embryos and fetal reduction for high order multiple pregnancies. Tubal reversal allows natural conception to occur.
- Most reports state that the success of tubal reversal surgery equals or exceeds IVF. The IVF procedure requires months of preparation, and weeks of injections, blood tests, ultrasound examinations prior to oocyte retrieval and embryo transfer.
- The tubal reversal procedure takes 1 - 2 hours to perform and 5 - 7 days for recovery. The IVF procedure requires weeks of preparation including injections, blood tests, and serial ultrasound examinations.
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