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Article ContentMaking Your Decision
The decision to take steps to have more children is one of the biggest and most important decisions a couple can make. The following are some questions that couples consider frequently at this stage.
The (doctor|surgeon} who tied my tubes told me he would "cut, tie and burn my tubes" and that it would be permanent and irreversible. Does this mean that they can't be fixed? (Tubes can be fixed about 90% of the time even when patients were told this. As physicians we are trained to make absolutely sure that tubal sterilization is truly what the patients want to do, and sometimes this leads to some amount of exaggeration when the operation is discussed. However, the type of tubal ligation operation is very important. It is really desirable to get a copy of the operative note from the hospital where the tubes were tied, because a very small number of doctors perform a "fimbriectomy" to block the tubes, and this kind of procedure is essentially impossible to repair. Estimates in the dictation or the pathology report of the amount of tube damaged or the amount of tube left are completely unreliable, in our opinion, and should almost never be used to make a decision about operability. Call the medical records department of the hospital and ask for the forms to fill out to get your op note. Getting these records is your right as a patient, and any charges should be very minimal. We would be happy to review your op note to assess your chances of repair. After you have the op note, phone our office manager for a fax number. Dr. Doody will personally read the report (for free) and get back to you.)
Do I want to do this, or is this only for my partner? (One of the most common reasons for a tubal reversal is remarriage to a new husband who has never had children. The decision to try to have another child in this situation has generally been made before the remarriage.)
* If I do really want to do this, how does my partner feel?
* Can we afford this now?
* Are there spiritual aspects to this decision? (Pray about it!)
* Would the availability of low interest financing make this procedure more attractive as an option?
* Can we afford a baby? (Go to www.babyzone.com or www.babycenter.com for tons of information on this subject. These are huge sites, so don't forget to bookmark this site before you go.)
* I am overweight. Can I still have this procedure done? (Yes, but it may affect the way the procedure is done.)
* I am latex allergic. Can I still have this procedure done? (Yes.)
* Is the wife's age such that fertility is decreasing? (This starts in women after age 35 to some extent and is a major factor after age 40.)
* If over age 35, should we speed things up or on the other hand consider not doing the procedure?
* How many children will we want in the future?
* What will a new child do for me? My partner? My other children?
Is the (doctor|surgeon} that I am considering a subspecialist? (His or her web site would probably say so. If not, simply phone to ask the office receptionist "Is the (doctor|surgeon} a Reproductive Endocrinologist?" This is an assurance of completion of the basic years of microsurgical training and a real commitment to reproductive problems. Because of the wide number of choices available to you, you need at least one "litmus test" for this life-altering decision. This is one of them. If for whatever reason you do not conceive in the future, you do not want to have any regrets about how you chose the surgeon. )
Do I understand what is involved with the operation?
Is In Vitro Fertilization a better option for me at this time? (If cost is not a major factor but time is, then IVF may be the better option. On a "dollars per baby" basis, tubal reversal is over twice as effective as IVF, but the results of IVF are known much faster. Generally, the wealthier a couple is, the more attractive IVF seems. On the other hand, tubal reversal allows the option to have more than one pregnancy in the future. Building a large family with IVF would require multiple procedures. Multiple pregnancies are NOT a good outcome, and approximately 30-40% of the pregnancies with IVF are multiples! Tubal ligation reversal does not increase your chance of having a multiple pregnancy.)
Is adoption a better option for us at this time? (Adoption is usually more expensive than tubal reversal, but it may be a better choice for a much older couple.)
If I am a smoker, can I quit in order to give myself a better chance? (You will have to quit when you become pregnant anyway!)
Were the previous pregnancies healthy? If not, are these problems likely to return?
Are there new medical problems now which might influence a pregnancy? (If so, ask the (doctor|surgeon} who is taking care of them whether a pregnancy would be possible.)
What are the costs involved in travelling to have this done? ( www.travelocity.com can give you a quick estimate of airfare. You will have to fill out a short registration form, but this is not a commitment to buy tickets on the flights you are asking about. Ask about flights more than one month in advance to get the best quotes. Remember to add in the cost of several nights in a hotel room. Our offices can give you the phone numbers of inexpensive hotels nearby. )
How important is a financial guarantee to me? (Beyond the financial implications of a guarantee, keep in mind that it is an excellent indicator of a doctor's success rate as well.)
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