Regrets About Sterilization

“You have to be absolutely sure.” Any man having a vasectomy or woman having her tubes tied would probably say, “I am sure.” But they may feel differently a few years later—life has a way of changing things.

The classic example of regret after sterilization is a person who goes on to marry a new partner after divorce. Couples who lose a child, or whose circumstances change in other ways, also may wish for more children. “Studies show that the biggest factors in female regret are being single and under age 30 when you make the decision,” says obstetrician/gynecologist Joseph Patruno, M.D., of Lehigh Valley Hospital and Health Network.

It is possible to reverse either a vasectomy or a tubal ligation, especially with today’s surgical techniques. But it’s also becoming less necessary. “There are good long-term contraceptive options such as IUDs,” Patruno says. And in vitro fertilization offers many advantages over reversal.

Reversal: His

Vasectomy is a simple, common and reliable form of sterilization, says Patruno’s colleague, urologist Daniel Silverberg, M.D. Reversal involves microsurgery (under anesthesia) to reconnect the severed ends of the tiny tubes that carry sperm. “It then takes several months for the testicles to start producing sperm again,” Silverberg says. The cost is about $5,000.*

For a man who had his vasectomy less than five years ago, the chances of achieving pregnancy average about 75 percent, Silverberg says; after more than 5-10 years, they drop to 50 percent. (If vasectomy reversal fails, sperm can be removed from the testes and used for in vitro fertilization; see below.)

Reversal: Hers

For women, too, reversal means surgically stitching the tubes back together. First, there are exams to make sure ovulation is taking place, the uterus is normal and enough fallopian tube remains for reattachment. “There are different techniques for tubal ligation, and some are more likely to be reversible than others,” says Wendy Schillings, M.D., a fertility specialist at the hospital.

Typically, the $15,000* surgery is similar to a c-section in terms of scar size and recovery time, Schillings says. The chances of pregnancy afterward average 50-60 percent, depending on the woman’s age and other factors.

Going the IVF route

For about the same cost as a tubal reversal, a couple can have a cycle of in vitro fertilization (removing eggs from the ovary, fertilizing them in the lab and placing the resulting embryo in the uterus). “It’s less traumatic for you physically, we can select the most viable sperm, the success rates are comparable depending on age, and you may have embryos frozen for the future,” Schillings says. About three-quarters of her patients now choose IVF over tubal reversal.

While all these options are good news for the people who need them, the bottom line is still clear: If you’re at all unsure, don’t choose sterilization.

Want to Know More about vasectomy? Call 610-402-CARE or click here.

*Most Pennsylvania insurors do not cover sterilization reversal or IVF.

Published from Healthy You Magazine, September-October 2007

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