New Year Brings New Birth for Once-Sterile Chicago Mother
Jan 04, 2011
Weiss Memorial Hospital surgeon provides hope with laparoscopic tubal reversal
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CHICAGO – Jan. 4, 2011 – Jeanette Custodio thought she would never be able to have another child, but she’ll be spending 2011 as a new mom once again. Custodio delivered a healthy girl on Jan. 1, her first child with her husband, Ruben. Custodio underwent tubal ligation sterilization eight years ago; but last December, the then 30-year-old Chicago woman underwent a laparoscopic tubal reversal that gave her hope in getting pregnant again.
The surgery, which repairs and reconnects the fallopian tubes to restore fertility, was performed by Carlos Rotman, M.D., chief of gynecology and medical director of Women’s Health at Weiss Memorial Hospital and associate professor of obstetrics and gynecology at Rush Medical College. Dr. Rotman, who specializes in advanced minimally invasive laparoscopic surgery, said Custodio was the ideal patient for this procedure. “She is early in her child-bearing years and had no serious health conditions,” he said, adding that there are many women who are excellent candidates for the surgery.
After Custodio and her then boyfriend had their third child, she got a tubal ligation, a surgical sterilization procedure that is 99.5 percent effective as birth control. But the nine-year relationship ended. Custodio eventually married, and she and her husband wanted to have a child of their own. Her situation is common; a new relationship with the desire to have children is cited as the number one reason a woman decides to have a tubal ligation reversal procedure.
“I couldn’t believe how quickly everything happened,” Custodio said. “I thought I couldn’t have children again, and then I saw Dr. Rotman. Within three months, I was pregnant.”
A recognized leader in his field, Dr. Rotman has created and advanced new techniques and instrumentation in the field of laparoscopic surgery. He is one of few doctors who routinely perform tubal reversal laparoscopically, for which he has one of the highest academically published success rates (pregnancy after reversal) in the world—a 79 percent pregnancy success rate in women aged 35 and under who undergo bilateral laparoscopic tubal reversal. The success rate with the traditional open technique is between 60 and 80 percent.
“Dr. Rotman made me feel comfortable from the start about the procedure and the chance of getting pregnant again,” Custodio said. Dr. Rotman typically advises his patients to wait three months after surgery before trying to get pregnant so the tubes can heal properly.
“Jeanette’s success with this procedure illustrates the possibilities for other women who have undergone tubal ligation,” said Dr. Rotman. “I am delighted to see her have results so quickly and have such a healthy pregnancy.”
An estimated 700,000 to one million women undergo tubal ligation sterilization each year in the United States; it’s the most common contraceptive method worldwide among married women (33 percent). Tubal ligation closes off a woman's fallopian tubes, muscular organs connecting the ovaries to the uterus. Surgeons cut, burn or block the fallopian tubes with rings, bands or clips, which prevents eggs and sperm from meeting each other for fertilization. Even though tubal ligation is considered a permanent form of contraception, approximately 10 percent of women have a change of heart and want to become pregnant again, and for many of these patients, this can be achieved through tubal reversal.
In the laparoscopic tubal reversal procedure, small, specially designed instruments are used to repair and reconnect the fallopian tubes. After general anesthesia is administered, tiny incisions—the largest one is one centimeter through the belly button, and up to three others in the abdomen are only half that size—are made. Using a surgical scope attached to a tiny camera to view the abdominal cavity, the surgeon removes the blocked area of the fallopian tubes, reattaches the remaining portions and sutures the tubes together.
The minimally invasive procedure allows the woman to go home the same day. It also results in faster recovery, better healing, less pain, fewer complications and no large scars compared to traditional open surgery.
An alternative to tubal reversal is in vitro fertilization (IVF). Although women undergoing IVF avoid risks associated with surgery (e.g., infection or adverse reaction to anesthesia), the biggest disadvantages of this procedure are the medications needed to stimulate the development of multiple eggs (which are not without possible complications), the many trips by the patient and her husband to the doctor’s office, and the high costs often not covered by the patient’s insurance.
“This time last year, I was uncertain I could conceive again,” Custodio said. “Now I sit here in amazement as I hold my beautiful new daughter, feeling extremely blessed.”
For more information on laparoscopic tubal reversal or Women’s Health at Weiss Memorial Hospital, call (773) 564-6025.