Will Health Insurance Companies Pay for Tubal Reversal Done for Tubal Ligation Side Effects?
Most women who undergo having their tubes tied have few if any side effects of tubal ligation to cope with. However in a small proportion of cases, Post Tubal Ligation Syndrome may be encountered. This is a hotly disputed area if you do suffer from the symptoms with many doctors refusing to accept the existence of PTLS at all. Here we will look at Post Tubal Ligation Syndrome and insurance companies view on the subject.
Tubal Ligation Side Effects
Some 14 tubal ligation side effects were well documented by Dr. Vicki Hufnagel in 1980 in her very comprehensive study of tubal ligation patients. Some of the effects are minor, both physically and psychologically, and may fade with time.
But unfortunately there are recorded cases of a much more serious nature. Violent mood swings, depression, hair loss and heavy bleeding represent real dangers and risks both to the patient and those around her.
How to Recover from Post Tubal Ligation Syndrome
In such serious cases, the only and best answer is tubal ligation reversal in the hopes of restoring the body’s balance. This is where things get a little tricky to say the least. Not with the procedure, which is highly successful and safe, but with financing this reversal operation. This is down to the fact that not every medical profession agrees with the studies that have been done so far.
Tubal Reversal and Health Insurance
A standard tubal reversal, not driven by a medical need, generally will not qualify under your insurance if done for non-medical conditions. It is classed as an elective procedure. Pretty much all private health insurance companies take this view.
Claims for a tubal reversal due to Post Tubal Ligation Syndrome and coverage from insurance can result in a different outcome. Where we are talking about pressing medical needs, or a recommendation by a doctor, we start to approach a borderline decision for these companies. But Post Tubal Ligation syndrome and insurance companies don’t always see eye to eye
In all likelihood, your health insurance company will want to see all of the medical files associated with your case. They may appoint their own experts to assess it and maybe even examine you themselves.
Problems PTLS Sufferers Face with Insurance
For PTLS sufferers this is where problems can start as it is not widely accepted or recognized in the medical profession. You may have a fight on your hands. It is best to accede to their demands in the first instance of letting them see your medical records especially if your doctor is on your side and has well documented your case until you know where you stand.
The key in all of this is to work closely with all of your health care professionals and speak to your insurance company as early as possible. By actually introducing this dialogue at a stage where they do not feel pressured by its urgency, you might actually get a few breaks.
If this still doesn’t work, there are some insurance companies, such as Looking for Anthem Blue Cross Health Insurance Plans? Visit Blue Cross Blue Shield (and you can get a free quote from eHealthInsurance
), who will pay for reversal operations in certain locations under certain conditions. This will often pay for reversal to remedy the tubal ligation side effects and will benefit the suffering patients accordingly.
Get Part of Your Tubal Reversal Paid For
In any event even if your insurance company will not finance the whole procedure, you might be able to exploit a loophole to cover a portion of the surgery. This is likely to be the pre and post examinations/consultations, testing and some exploratory costs. So you could be looking at getting things like any initial consultations, blood tests and some parts of the operative costs like the anesthetist paid for.
What is the most important thing is to ensure that your Post Tubal Ligation Syndrome symptoms and the health insurance company are dealt with as swiftly as possible before your symptoms make your life unbearable if you should have the worst of the tubal ligation side effects.
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Tubal Reversal Success Rates – How Effective Is Tubal Ligation Reversal?
Before we begin to discuss how effective is tubal ligation reversal,or the tubal reversal success rates, let’s start with a little background about tubal ligation numbers.
Every year over 600,000 women choose, or in any event undergo, sterilization via tubal ligation or other associated methods. For many this is the right decision at the right time.
However a proportion of these often come to regret their choice or wish to reverse the procedure due to changed circumstances. The official figures are around 25% regret their previous surgery within the first 3 years following the sterilization procedure. If the reverse is due to a desire to bear a child again, then it is sensible to know how effective is tubal ligation reversal.
Tubal Reversal Success Rates – Studies on the Effectiveness of Tubal Reversal
For a lot of women in the lead up to a decision on tubal reversal, there is a search for knowledge and information. The question as to how effective is tubal ligation reversal can be all absorbing. After all, who wants to spend thousands without having some knowledge as to what the tubal reversal success rates are.
Unfortunately the quantity and quality of information can be sparse to say the least. Figures are quoted in quite high percentages as to the “success” of the reversal procedure. But more often than not, there is no qualification, clarification or a lack of solid evidence to back them up, even if true.
In fact although you would assume that a “success” would mean pregnancy, it is difficult to know. Is it just the successful completion of the operation itself in a technical way? We know from medical figures that fallopian tube surgery is generally successful about 98% of the time from hospital records. But that in itself does not guarantee pregnancy will follow.
There can be issues if the 2 ends of the fallopian tube being joined are of different diameters, or if the length of the 2 halves is less than about 4 inches. There are other factors to consider when looking at how successful a tubal ligation reversal may be. The method of ligation, patient age and experience of the surgeon all play an important part.
As there have been no government or academic studies done on tubal reversal success rates, what are you to do? Has anyone actually done a proper study from surgery to pregnancy, or the lack thereof, to determine the success rates of tubal ligation reversal? Are there actual figures to show the pregnancy rates for all the different circumstances? This is important for any women thinking and wondering just how effective is tubal ligation reversal.
Chapel Hill Tubal Reversal Center Study on How Effective Is Tubal Ligation Reversal
The only real in depth study that has been done in significant numbers is that by Dr. Gary Berger of the Chapel Hill Tubal Reversal Center. This was done with records starting in 2000 and going through 2008 and a follow up report published in 2009. If you need to look, it is called the Tubal Reversal Pregnancy Study 2009 Pregnancy Rates by Age and Tubal Ligation Method.
If we crudely summarize, then the study showed that on average, that pregnancy rates, or effectiveness, of tubal ligation reversal was around 66%. Now that was an averaging out of the pregnancy rates recorded, by cross referencing age and original ligation method. What was clear was that age was the biggest factor by far.
To look in detail at how good is tubal ligation reversal is a rare privilege. The actual detailed figures from this study are split into 3 parts.
Pregnancy Rates – How Effective Is Tubal Ligation Reversal
The first of those looks at 3 age groups and the variations across those groups for the various original ligation methods used. One thing was very clear, is that women aged under 30 had a much better chance of pregnancy than the other groups. 80% was the figure and that dropped rapidly across all methods to a figure of 31% when over 40.
The effect of the original ligation method was not as much of a factor in determining how effective is tubal ligation reversal. Ring or clip ligation came out top of the pile with 72% and 75% respectively.
Finally we can look at the cross referenced figures which clearly shows age as the determining factor again. The best statistics show that those women under 30 who had undergone clip form of tubal ligation surgery had a massive 90% chance of the tubal ligation reversal being effective and resulting in pregnancy. However, the number of women under 30 wanting a tubal reversal is a smaller group as most of the women wanting this reversal surgery were in their 30s.
Even when over 40, it appears that this ligation method vastly reduces the failure rate, so that pregnancy has a 31% chance. The figures for Ligation/Resection are 77% for under 30 patients and 31% for those over 40. The best type of tubal ligation to want to reverse for the over 40 group according to the Chapel Hill Tubal Reversal Center is ring tubal ligation as it had a 46% pregnancy rate.
What About the Tubal Reversal Success Rates of Other Tubal Ligation Procedures
As a side point, we need to talk about Essure sterilization. This is a very different method of tying the tubes, where the insertion of a metal coil encourages the tissue in the fallopian tubes to grow and seal them up. It was often thought that reversal success would be minimal from this method.
This has not been the case though. Dr. Berger has already seen success with this reversal type. Given that the population of women who have had reversals of Essure or even Adiana sterilizations, there just is not a good population size to give out success statistics. Suffice it to say, there have been some successes.
How Successful Is Tubal Ligation Reversal? – Tubal Reversal Success Rates
Now the really great thing about these figures, is not only to demonstrate how effective is tubal ligation reversal in itself, but how there needs to be careful consideration of ligation method prior to any sterilization. Of course, when tying your tubes, who thinks they will want a reversal some day.
It would appear that if you are under 30 then going for rings or clips Fallopian tube method will give you the best chance overall. But as you creep towards 40, although better, the gap between the methods and successful reversal recovery drops. Of course Essure and Adiana removal really is the bottom of the pile being a much more involved tubal ligation reversal proces, so perhaps should only be considered as a last resort.
Of course all of these tubal reversal success rates will also depend on the skill of the reversal surgeon on the day which will determine how effective is tubal ligation surgery for you. Keep this in mind besides everything else when you begin looking around for a surgeon to perform your tubal reversal.
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5 Things to Do to Help Getting Pregnant after Tubal Reversal
The tubal ligation reversal operation is a lifeline to many women desperate to have another child or to reverse what they see as mistakes of the past. The procedure is simple and can result in pregnancy soon after in about 70% of cases, subject to circumstances.
But waiting to get pregnant can be frustrating and having help getting pregnant after tubal reversal can be an absolute life saver to many. Here are 5 basic things you can do to help conceive after your tubal ligation reversal surgery.
Follow Your Doctor’s Instructions
The initial part of the help getting pregnant after tubal reversal you should receive is the follow up by your doctor. He should provide guidance on how the operation went and advise you as to good and bad habits going forward. If you don’t get this automatically, you should be asking for it.
One thing to take note of is what he tells you to do if you don’t conceive within a certain amount of time. This could include a HSG test in a year if you can’t get pregnant following your reversal surgery.
But in any event there are 4 other things you can personally do to improve your own situation.
Nutrition and Vitamins
The best way to get your body back into full working order is to follow a regimen of healthy eating including plenty of vitamins. This means eating lots of good vegetables and fruits along with the right amounts of protein, carbohydrates, and healthy fats. All of these are needed to heal your body and to provide a healthy environment for a growing fetus.
You can of course give yourself a boost in the early days after tubal reversal by taking multivitamin tablets. Folic acid is well known to be essential for pregnancy success and helping to reduce the chances of miscarriages, still births and other birth defects. One 400g tablet a day could work wonders but, as with all things medical, follow your own doctor’s advice.
Be Aware of Your Medical History & Condition
Conditions you already have or may be susceptible to through genetics can have a big effect on your chances of getting pregnant and having a healthy pregnancy.
You must inform your doctor before and after your tubal ligation reversal of these conditions. If not conditions such as diabetes can be influential, even dangerous to the chances of conceiving.
You need to be sure that you are fully educated and have the ability to control diabetes or thyroid issues day after day. If not this could seriously affect you chances of both getting pregnant and successfully carrying full term.
If you are also taking any medication of any kind, even herbal, you must let your doctor know the full details. It would help more to actually bring them in to show him.
A few prescription medicines can be very harmful to both conceiving and to your growing fetus. There is plenty of documentary evidence of miscarriages or other defects being caused by some medications. Professional support getting pregnant after tubal reversal is vital to assess the medical dangers and risks if you should have any condition, disability, or disease that may affect your chances.
Stop Smoking!
Men are well aware that smoking seriously affects their potency and the motility of their sperm. Women know that smoking while pregnant can have serious consequences for the baby. It is no surprise then that smoking is thought to contribute to slow and poor healing of the fallopian tubes after ligation reversal. If it takes longer to heal, it takes longer to get pregnant.
Remember you are voluntarily taking a poison into your body by smoking. You may say that you have more chance of being run down, but you don’t deliberately go out and run into the road every day, do you?
Dealing With Irregular Ovulation
This can be a common problem after reversal surgery, depending on your age and how long you had your tubes tied for. If you are experiencing irregular periods or none for a long time, this is indicative of this problem.
Of course this makes it all the harder to conceive after tubal reversal for a couple. Appreciating this and taking what steps you can will always help getting pregnant after tubal reversal.
Fortunately there are ways of detecting ovulation, although it does require eternal vigilance. You can use an ovulation predictor kit. This obviously will let you know when ovulation is taking place and increases your pregnancy chances.
It is important that as part of this testing you write down the frequency of the egg release. It can be used in later consultations and makes the doctor’s job much easier to help getting pregnant after tubal reversal. It will certainly help you track ovulation after tubal reversal.
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