Factors Affecting Success Rates after Reversal

A woman’s age can be important

Around the age of 35, we are told that ‘natural fertility starts to slowly wane’. However, the exact age at which a woman will struggle to conceive varies considerably and depends on the woman. It is not as simple as… ‘at age 35’.

One of the most accurate ways of predicting your fertility, if you have been pregnant before, is by looking at your previous pregnancy history and how easily & quickly you previously found it to conceive.

For example… if someone conceives with ease aged 35, they probably won’t struggle to conceive aged 40. However, if a someone struggles to conceive aged 30, she may will really struggle when she is 35. So as you can see, age and fertility all depends on how easy you found it to conceive in the past.

Egg quality versus number…

Every month, the body recruits a group of ‘follicles’ in the ovary (follicles are little cysts with eggs in). One of these follicles will usually go on to release an egg mid cycle.

As a woman ages, the number of eggs left in the ovaries reduces, and towards the menopause cycles may become irregular and heavy as the body struggles to find an egg to ovulate. If this is the case then whilst pregnancy is still possible, it can take longer to achieve as an egg may not be released every month. (Periods may be irregular for reasons other than the menopause, such as PCOS, so see your doctor/ speak to Mr Dobson if you are concerned about your cycles.)

So if I am having regular cycles, and presumable has plenty of eggs, why is my age important?

Age is important as it is egg quality that declines with age, and so it can take longer to conceive, even if egg number is good.

For example… a 20 year old has 10 periods and releases 10 eggs… (9 of these eggs (90%) are genetically healthy and will result in a healthy pregnancy if they meet a sperm). As such she will conceive very quickly, usually within a few months. Now, consider the same lady but aged 40… If she now has 10 periods and releases 10 eggs, only 1-2 out of 10 (15%) of these eggs will be genetically healthy. As such, she can still get pregnant, but it will take longer to, as the sperm are having to wait longer for a month where the egg released is genetically healthy (which is less often than when she was 20).

If your cycle is irregular or there is a possibility that your ovarian reserve is low, Mr Dobson may discuss doing a blood test or ultrasound scan with you prior to your surgery. In the case of a normal ovarian reserve and irregular periods, Mr Dobson will be able to offer treatment in addition to reversal surgery to help improve your chances of conceiving.

Pre existing conditions of the fallopian tubes:

The fallopian tubes (tubes connected to the uterus which facilitate the fertilisation of an ovulated egg with sperm, before transporting the fertilised egg into the uterus) may sometimes have been damaged, even before your sterilisation took place. If this is the case, this can mean the reversal surgery may not result in the success rate that we would otherwise expect.

There are a few potential causes for this:-

* A history of pelvic infections (such as pelvic inflammatory disease or any sexually transmitted infections)

* A history of a ruptured appendix, surgery in the pelvis or lower abdomen

* A history of a miss-located (ectopic) pregnancy in the fallopian tubes

* Birth defects of the uterus and fallopian tubes

* Endometriosis

* Fibroids located at certain places within the uterus 

Male Fertility: One Of The Important Success Rates Factors

There are many treatable factors that can affect male fertility and it is important that you tell Mr Dobson about any of the following at your initial consultation:

* Obstructive problems (blockages in sperm-carrying tubes e.g. having cystic fibrosis)

* Testicular injury and disease

* Varicocele (swollen veins around the testes)

* Sperm disorders

* Genetic disorders

* Problems with erection and ejaculation

* Hormonal problems

* General medical disorders that reduce fertility

* Drugs that reduce fertility (e.g. testosterone therapy or anabolic steroids)

* Environmental toxins and radiation (e.g. related to your job)