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Forum Name: Obstetrics

Question: tubal ligation reversal vs IVF


 missdebbie1964 - Sun May 03, 2009 7:20 pm

I am a 44 yr old and have had a tubal ligation (clips) 13 year ago. I have 4 children from a previous marriage but have remarried to a 42 year old who has never had children. We have after long discussions decided to try to have children. We have had an initial IVF appt. and been told ICSI would be our best option ass my husbands sperm has a few issues - quantity is great some motility problems = not in all and some shape issues. We are now faced with the decision of Ivf which is costly and if it doesn't work the first time more costs are incurred or tubal ligation reversal whereby we can continue to try. My other question is that over the past few weeks my menstral cycle has been normal as usual but I have had some sharp knife like pains on my left side particularly when bending or sometimes when using my bowel, a bloated stomach odd feelings on the left side. Can you advise on what this may be and also which option you think would be best as far as trying for a baby.
 Debbie Miller, RN - Tue May 12, 2009 12:01 am

User avatar Hello,
I can't say what the cause of this distress is and would recommend an exam to determine if there might be an ovarian cyst or other abdominal problem since there are so many organs in the abdomen - bowel, bladder, ovaries, uterus, gall bladder, appendix, etc. There are many possibilities for cause of pain.

As for the pregnancy attempt there is the age concern. Fertility is greatly reduced after age 40-45 so your biological clock is ticking. If you had a tubal reversal (also expensive I'm sure) and then tried for a while, you could find you are having trouble conceiving and each month you get closer to menopause so you don't really have time on your side. It can take a while to get pregnant even if you had a completely successful reversal. Ovaries start to slow down. For this reason I think your chances for having a natural child would be best with IVF. It's true there's no guarantee, but that's the case with all your options right now. If you don't mind trying for pregnancy, while being prepared for the possibility it may never happen on its own, especially considering sperm motility concerns, go for it. But, it can be hugely disappointing to get your hopes up when perhaps it is not realistic.

Many older women successfully carry babies to term but those you see (superstars, etc.) often have used IVF, usually with donor eggs, in order to achieve this goal. There is a lot going on backstage that we don't hear about in the media. Thankfully some things are still private.

Most of the time, several eggs are harvested and conception is attempted. If you fail in your effort, the second time usually is not as costly due to the fact the eggs are already harvested. If cost is prohibitive, I understand you can sometimes travel to other countries (even some Soviet countries) and get the procedure which, including travel and lodging, still saves thousands of dollars over U.S. prices. Just something to consider and investigate on the internet perhaps.

Best of luck to you.

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