Will Tubal Ligation Reversal Become A Lost Skill?

Main Category: Fertility
Article Date: 20 May 2008 - 4:00 PDT

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To address the shortage of experienced tubal ligation reversal specialists, a tubal reversal surgery training program has been started at Chapel Hill Tubal Reversal Center.

An ominous forecast was made in a recent article in Fertility and Sterility, a medical journal for reproductive specialists: "The future for tubal anastomosis seems grim... and, like the Roman Empire, may be lost in Antiquity". This prediction was based on a survey of reproductive endocrinologists in training and in practice that showed decreasing numbers of tubal anastomosis procedures are being performed. Almost exclusive concentration on IVF (in vitro fertilization) and assisted reproductive technology (ART) has resulted in the absence of training of reproductive specialists in tubal reparative surgery. This article stated, "The success of surgical tubal anastomosis is directly linked to surgical experience. With the advent of ART, surgical training has markedly declined, and there remain few fellowship programs with meaningful numbers of surgical cases. One study reported that most of the current Reproductive Endocrinology and Infertility fellows performed less than 10 procedures and 35% of program graduates performed no surgical tubal reversals in the previous year."

This is grim news for the many thousands of women in the United States who have had their tubes tied and now want a reversal to have another baby or to obtain relief from post tubal ligation symptoms. Tubal reversal enables women to conceive naturally, is less expensive and has higher pregnancy and birth rates than IVF.To address this shortage of experienced tubal reversal specialists, a tubal reversal surgery training program has been started at Chapel Hill Tubal Reversal Center in Chapel Hill, North Carolina, where over tubal reversals are performed for over 800 women annually. Because of the high surgical volume, this provides the ideal situation for a doctor to become properly trained in performing tubal anastomosis. The training program was started in January 2008 by Dr. Gary Berger, a reproductive surgeon who specializes exclusively in performing tubal ligation reversals. Dr. Berger developed the outpatient technique for this operation in the early 1980's and has performed more than 7000 tubal reversal procedures.The first doctor who has begun the training program is Dr. Charles Monteith, an ob-gyn doctor affiliated with the University of North Carolina at Chapel Hill. When he completes this program later this year, Dr. Monteith will become the first doctor in the United States, or any other country, to be certified as a tubal reversal specialist.

When asked his opinion about the Fertility and Sterility article, Dr. Berger replied, "Tubal anastomosis will not become a lost skill. Other physicians will follow the path that Dr. Monteith has chosen to learn the skills and techniques required for successful tubal reversal operations."Chapel Hill Tubal Reversal Center is dedicated exclusively to performing tubal reversal surgery. The Medical Director - Dr. Gary Berger - is widely recognized as the tubal reversal doctor with the most experience with this procedure and is now teaching the outpatient techniques that optimize outcome, reduce recovery time, and minimize the cost of tubal reversal surgery. Future patients and their families will reap the benefits of Dr. Berger's passing on these skills.

References

http://www.ncbi.nlm.nih.gov/pubmed/15302313
http://news.tubal-reversal.net/pregnancy-study-2007-tubalreversal_vs_ivf.htm
http://www.tubal-reversal.net/blog/2008/tubal-reversal-doctors/pecialist-tubal-reversal-dr-monteith.html

Chapel Hill Tubal Reversal Center