Q&A: At 42, could I be a candidate for a tubal ligation reversal?

Ask A Doctor Question: 

I'm 42 years, in reasonably good health and I had a tubal ligation 13 years ago. Could I be candidate for tubal ligation reversal? If so, what is the average cost associated with it? Is it an outpatient procedure? And what does it basically entail?

- Obesia


Reproductive Care Center, MD -

The simple answer to your question is “Yes”.  You could elect to do a reversal of your tubal ligation.  The longer answer, though, is that conceiving a pregnancy at the age of 42, by whatever means, is not an easy task and has some risks.  Most importantly, the risk of conceiving a baby is potentially risky at your age.  The risk of having a baby with aneuploidy (abnormal number of chromosomes as in Down syndrome) is significantly higher at age 42 (1 in 30 vs. 1 in 400 at age 30).  Secondly, the chance of conceiving is very low, perhaps at less than 5% per cycle, and if you should conceive, the risk of miscarriage is 60% or higher.   Those numbers increase as you get older and time is of the essence if you’re going to try to conceive with your own eggs.
With regard to your choices for conceiving, one other option for someone with a tubal ligation is in vitro fertilization (IVF), a procedure that bypasses the fallopian tubes.  The obvious advantage for you would be the shorter time to conception (assuming it was successful) but the risks, as outlined above, would still apply.  With IVF, one can test embryos for aneuploidy prior to transferring them into the uterus and that could be of great benefit for older patients. 
A third option is IVF with donor eggs.  This option would not allow you to contribute to the genetics of the child but would significantly decrease the risk of aneuploidy (relative to the age of the egg donor) and thus increase the chance for a healthy liveborn.  Donors are also prescreened for genetic and infectious diseases and are often the best option for success (healthy liveborn) in women who are in their 40’s.
These decisions are never easy and I would encourage you to see your physician to discuss these options further.
--Dr. John Gililland, Reproductive Endocrinologist

--Reproductive Care Center, MD
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