IVF vs. Tubal Reversals - Which is Best?

Published: 12/14/2015

Risk Comparison

Mostly, if not all the time, fertility clinics will try to talk a patient out of a reversal of sterilization, trying to convince them that In-Vitro Fertilization is their better choice. This is usually done by "scaring" them about the risks of surgery and anesthesia, the "low success rates with a reversal of sterilization", the increased risk of an ectopic or tubal pregnancy, and "how safe" In-Vitro Fertilization (IVF) is. It is true that there are risks to any surgical procedure; but the truth is, that the risks and complications of surgery and anesthesia from a reversal of sterilization are rare. Think about it. Where could you be safer than in a major medical center's out-patient facility with board certified anesthesiologists? Frankly, the two biggest risks are not surgery and anesthesia, but driving from your house to the doctor's office on major highways, and pregnancy itself. Don't kid yourself. Pregnancy doesn't come without potential risks, and as you know, there can be many different complications during pregnancy and at birth. Highway fatalities occur more often than any risks associated with elective surgery in a young healthy woman. Women are willing to take these two risks everyday.

Maybe it is a good thing, because most fertility specialists are not well trained in doing reversals of sterilization. Most current REI (reproductive endocrinology and infertility) fellowships have little or no training in microsurgical reversals of sterilization, and put most, if not all, their emphasis on training them to do In-Vitro Fertilization (IVF). That is not a bad thing, because In-Vitro Fertilization (IVF) can be a successful procedure, but a woman needs to know all her options and those options need to be presented to her without bias. Once the pros and cons of each procedure is discussed, including financial costs, success rates and logistics, and done unbiasedly, then the couple can make their choice as to what procedure is best for them. "Quite frankly, In-Vitro Fertilization (IVF) is much easier to do than standing for an hour or so in surgery, and a clinic makes more money".

Besides "scaring" them with the risks of surgery and anesthesia, it is argued that if you do In-Vitro Fertilization (IVF), not only will you not have to undergo major surgery and lose time for recovery, but also you will not have to worry about future birth control and having to deal with a future sterilization for you or your partner. Arizona Center for Fertility Studies's answer to that is, "if you are having to worry about birth control in the future, that is a good problem to have".

Cost Comparison

From a more practical point of view, a reversal of sterilization costs much less than a single attempt at In-Vitro Fertilization (IVF), and you can continue trying to get pregnant, "at no charge"; whereas, with In-Vitro Fertilization (IVF), a single attempt is more expensive than the reversal and if you are not successful, subsequent attempts at In-Vitro Fertilization (IVF) continue to cost more money.

The cost of a reversal of sterilization at Arizona Center for Fertility Studies is $9,109. This includes everything but the initial consultation which can be used as a credit toward the surgery, and current HIV and hepatitis B and C, which can be done by your PCP and covered by insurance.

In-Vitro Fertilizaton (IVF) costs around $11,500 plus medication costs and generally takes 1-3 attempts to be successful. It also requires a work-up (costing about $1,500) to be sure not to overlook anything that could affect the success of the In-Vitro Fertilization (IVF) procedure.

With the reversal of sterilization, most couples will waive the work-up, because, if something is "missed", it can always be tested for and treated later and nothing is lost financially other than a little time.