Most people are not aware that tubal ligation - usually considered a permanent method of birth control - can be reversed through one hour outpatient surgery. This article reports the outcomes of a large population of women who have had tubal ligation reversals at Chapel Hill Tubal Reversal Center. This is the largest and the most detailed follow-up study of tubal reversal patients in existence.
The study population consisted of 2692 women who underwent tubal reversal surgery between January 2001 and December 2004 . This method of following a group of individuals over time looking for specified outcomes is called a prospective cohort study.
The tubal reversal operations were performed using surgical and anesthetic techniques developed by Dr. Gary Berger. These techniques minimize pain, bleeding, operation time, and post operative recovery time. The surgical techniques, as well as the entire outpatient procedure, are explained step-by-step in a video of outpatient tubal reversal that has been shown in the series called “The Operation” on Discovery and The Learning Channel.
During the follow-up study interval after tubal reversal surgery, 1,783 (65%) of the 2,692 women had reported pregnancies. Younger women had higher pregnancy rates than older women. The pregnancy rate after surgery ranged from 77% for women under 30 to 34% for women over 40 years of age and older.
Tubal reversals of tubal ring or clip procedures were the most successful, followed by coagulation and ligation/resection procedures, but the differences in pregnancy rates for the latter two methods were relatively small.
The fallopian tube lengths remaining after a tubal ligation procedure are important determinants of the success of tubal reversal surgery. Women with longer tubal lengths had significantly higher pregnancy rates than women with shorter tubes following tubal reversal. Women with tubal lengths 7.5 cm or longer had a pregnancy rate of 77%. The pregnancy rate declined as tubal length decreased, but even women with the shortest tubes (less than 2.5 cm) became pregnant (24%).
Long tubes were also associated with better pregnancy outcomes than short tubes. Among women with average fallopian tube lengths measuring 7.5 cm or longer, 59% gave birth or had an ongoing pregnancy. Birth/ongoing pregnancy rates declined while miscarriage and ectopic pregnancy rates increased with shorter tubal lengths. The ectopic pregnancy rate after tubal reversal is higher than the 2% ectopic pregnancy rate in the general population.
On the Internet, claims about tubal reversal pregnancy rates are often made without supporting information or documentation - such as a description of the patient population, study method, and follow-up interval. Most internet sites about tubal reversal do not provide any factual data at all. Any doctor may say that his patients have a particular success rate, but supporting the claim with actual data involves considerable effort. Performing a follow-up study such as this one requires keeping an accurate record of patients and their findings, as well as maintaining ongoing patient contact to determine the outcomes of treatment. That is the only way a doctor can actually know what the pregnancy and outcome statistics are for his patients.
At Chapel Hill Tubal Reversal Center, nurses enter information into an electronic patient database at the patient’s registration, the surgical procedure, and from regular post-operative communications with our staff. If we have not heard from patients after their recovery from surgery, our nurses contact them at 6 and 12 month intervals. We know of no other doctor, hospital, or clinic that maintains such ongoing patient follow-up records after tubal reversal surgeries.
© Chapel Hill Tubal Reversal Center 2006
Gary S. Berger, MD
Medical Director
Chapel Hill Tubal Reversal Center
109 Conner Drive Suite 2200
Chapel Hill, NC 27514
Tel: (919) 968-4656
Fax: (919) 967-8637
Website: http://www.tubal-reversal.net/
The desire to increase semen production is common among men throughout world and the reasons are various; ranging from hopes of increased fertility to a desire for a more intense orgasmic experience. While many men are content to sit on the sidelines and wish, many others are finding out that the ability to increase semen production is easier to achieve than most believe.
There are a number of men would like to increase semen production, but due to certain circumstances, they believe that they will be unable to achieve this goal. For example, some men believe that difficulty in maintaining an erection or experiences with premature ejaculation might create a situation where increased semen production is impossible. While it is true that either scenario will cause a reduction in sperm count, there are supplements that can help control these symptoms in addition to aiding in increased semen production.
For those who wish to increase semen production, it has been discovered that the best way to achieve the goal is by utilizing supplements that have been scientifically designed for this specific purpose. While many methods have been tried throughout time, none have been able to meet the efficiency of natural supplements. For example, the previously promoted penis exercises, while thought to have been beneficial at one point in time, have recently been proven to be highly damaging to the penis and should not be practiced. The use of supplements has been accepted as not only a much safer route, but also a more effective one.
Intense research has discovered the key to developing more ejaculation fluid lies in supplements providing a high level of amino acids. Many male enhancement herbal supplements include amino acids and are known to be quite successful not only in increasing the sperm count, but also in rectifying other issues of male virility, such as erection quality, stamina, and desire. Often termed sperm pills, the majority of these supplements include natural ingredients. A variety of these products are available on the market, and there are websites dedicated to comparing and reviewing different products for consumer review.
It is important to note that sperm pills combat not only virility issues such as erection quality and stamina, but also the ejaculation process, itself. Not all male enhancement products contain the necessary high level of amino acids to increase semen production or be properly termed sperm pills. Because of this, some research into the ingredients that the different supplements contain is necessary.
The use of one of sperm pills can greatly enhance one’s sexual experience in addition to increasing semen production and sperm activity. The additional ejaculation fluid produced will result in increased intensity and duration of one’s orgasms.
About The Author
Dr. Michael Rodriguez is an innovator who has spent the past decade researching male sexual health.
See the only product that he endorses at: http://www.macaenhancer.com; macaarticles@abmarketers.com
Affordable Fall Fashion 2005: Use Hollywood as Your Guide
This Fall, fashion mixes the glamour of old school Hollywood
with a few new school twists. The teenie bopper icons of the
past few seasons, like Paris Hilton and the Olsen Twins, have
been replaced by Kathryn Hepburn, Mama Madonna, Grace Kelly and
young in love Demi.
So to prepare you for fall, take a little trip to your local
video store (or netflix) and rent the following:
Interview with a Vampire: The Vampire Chronicles
Why Rent: The flowing “romantic” shirts, the deep rich fabrics,
the velvets and the brocades are right off the pages of Vogue.
Featured: Roberto Cavalli Velvet Dress Budget: Express,Forever
21, Old Navy, H&M
An Officer and a Gentleman
Why Rent: Richard Gere….and military style coats are a must
have for fall. Please be careful not to go overboard a la
Michael Jackson. Stick to wool and cotton versions (with between
2-5% spandex/lycra content) in black, navy blue, and winter
cream.
Featured: Valentino Red Belted Military Coat, $995.00 at
Saks.com Budget: Gap, Tommy Hilfiger, INC, Asos.com, Esprit.
(Wo)Men in Black
Why Rent: Black is back with a vengeance- from updated cocktail
dresses to thick cable knit sweaters. For those in cooler
climates, wear black from head to toe. For those in warmer
climates, mix in other colors such as pumpkin orange, steel
gray, or your metallic pieces from the summer.
Featured: Donna Karan Collection Wool Shrug & Off-the-Shoulder
Dress, $495.00-1195.00 at NeimanMarcus.com Budget: Bluefly.com,
The Limited, Kenneth Cole Outlets
Doctor Zchivago
Why Rent: Fur is everywhere this fall from collars on tweed
suits to big hats to luxurious coats. If you’re not a big fan of
fur, try faux fur sellers like Fabulous Furs.
Featured: Peter Som Fall 2005 Budget: Salvation Army, J.Crew,
Consignment shops, Fabulous Furs
The Aviator
Why rent: Howard Hughes had a thing for Kathryn Hepburn and
Kathryn Hepburn had a thing for tailored menswear. Take a cue
from this cinema queen and fill your wardrobes with tailored
suits and separates in traditional suit fabrics like houndstooth
and tweed.
Featured: Theory Striped Suit & Shirt, 95.00-390.00 at
NeimanMarcus.com
Budget: Jones New York Outlet stores, Macys, Bloomingdales, The
Limited, H&M
Health issues differ somewhat between men and women. We read so much about diet and nutrition for women, so I think its about time men had a look in!
So… here are some of my Top Foods for men.
Pumpkin seeds, Brazils, Walnuts, and Almonds
Nuts are often regarded and shunned as high-fat foods, with little understanding of their nutritional value. Some nuts are very high in fat; Brazil nuts are about 70% fat, so you wouldn’t want to eat too many at once, BUT only 10% of this fat is actually saturated, so as you can see the vast majority is “unsaturated” and therefore either essential, or potentially useful for the health of every cell in the body. The term “essential” in this context simply means our bodies do not manufacture certain fats (especially Omega-3 and Omega-6 fats), which means that the only ways of obtaining them is through the foods we eat… essential to life, so therefore essential to the diet! Most fresh unsalted and un-roasted nuts and seeds (NO… not S*NP*T peanut butter - UK readers will know what I mean here!), as well as oily fish such as salmon, avocados, vegetable and seed oils, and olive oil contain mostly essential fatty acids - in other words fats that we need and which are put to good use in the body. A handful of walnuts have as much omega-3-fatty acids as 3 ounces of salmon, which may help in light of the recent and on-going worries about farmed salmon. Not only do omega-3 fats help towards preventing heart disease, they also help to prevent arthritis and depression.
A 25g portion of brazils (about 10 nuts) would be an ideal snack or addition to cereal or fruit in the morning. It would give you a respectable 170 kcals, and 17 grams of fat. About 70g of fat in one day is acceptable, so as part of your whole diet, they are not fattening! Brazils are one of the highest food sources of the mineral selenium: an antioxidant that plays a vital role in the health of the heart and CV system, as well as the thyroid gland. Selenium is also regarded as a potent anti-cancer agent. It is often lacking in British diets, due to a drop in soil levels over the years and consequently a drop in crops. However, all is not lost if you eat a few Brazils on a regular basis… the above 25g portion would give you 383 micrograms (ug), way over the UK RNI of 45-75ug, so even half that amount would still be beneficial!
Seeds (especially pumpkin seeds) are considerably lower in fat than nuts; pumpkin seeds are only 45% fat, and again the majority is unsaturated. They are also higher in protein than many nuts, and contain more zinc too. Nuts are still a good source of protein, with almonds providing the highest amount, as well as the highest amount of calcium. Brazil nuts come top of the list again when it comes to magnesium, another essential mineral for men that works closely with calcium in bone and muscle function.
As you can see it is variety that counts and as we know it certainly provides the “spice” of life, but also provides the key to obtaining the full spectrum of nutrients we need to be healthy on a daily basis.
Did you know?
The body of a sperm contains 86% monounsaturated fat! So, healthy sperm need healthy fats (as well as a good dose of selenium!). The foods with the most similar fatty acid profiles to that of sperm are olive oil and macadamia nuts, but all the above foods come pretty close too! So guys, maybe this piece of information helps to put things a little more into perspective?!!
Flaxseeds and your Prostate
Some recent research showed men with early stage prostate cancer who ate a low-fat diet plus three tablespoons of ground flaxseed daily for just over a month saw their PSA levels drop. They also saw their testosterone and cholesterol levels go down. PSA, or prostate-specific antigen, is an indication of tumour growth. The men who had more advanced cancers saw the PSA scores continue to rise. But researchers speculate that had they stayed on a flaxseed diet longer, they might have seen some benefit as well.
Flaxseed is high in fibre, lignans and omega-3 fatty acids, all of which may help fight cancer.
Soya foods
Versatile soya foods include tofu, soya beans, and fermented products such as Tamari or soy sauce, and miso. Not only are they one of the best sources of vegetable proteins, but soya foods also boast the presence of plant substances called “isoflavones”. These have a number of health benefits for men. Soya protein helps to lower the amount of unhealthy LDL cholesterol in the blood, and soya isoflavones are now known to be protective against prostate cancer, as well as heart disease.
Firm tofu is the best way to enjoy soya’s health benefits. Contrary to popular belief, tofu really can be edible, and even tasty. To get the most from your tofu, try marinating it in soy sauce, lemon juice, oil, and herbs, then bake, grill or stir-fry it with your choice of veggies. If you have never contemplated using tofu, try the following recipe, which is delicious, quick and easy.
Quinoa Risotto with Tofu and Asparagus
Serves 4
1 tsp olive oil
2 tsp garlic, finely chopped/minced
1 cup red onion, finely diced
1/2 cup sun-dried tomatoes, cut into thin strips
2 cups vegetable stock
2 tblsp fresh lemon juice
1 cup quinoa, rinsed
1 tblsp lemon rind
1/2 tsp freshly ground black pepper
1/2 lb firm tofu, cut into 1/2 inch cubes
1/2 lb asparagus, cut into 11/2 inch lengths
1/2 cup toasted cashews
Heat the olive oil over a medium heat. Sauté the garlic and onion for about one minute. Add the sun-dried tomatoes and sauté for a further minute. Add the vegetable stock, lemon juice, quinoa grains, lemon zest, black pepper and tofu. Cover and simmer 15 minutes. Place asparagus on top, cover and continue cooking for a further 5 mins. Sprinkle with toasted cashews.
Nutrition Facts:
Per serving (330g): 435 calories, 24 g protein, 17 g fat (3 g saturated), 48 g carbohydrates, 40 mg cholesterol, 325 mg sodium
Quinoa
Quinoa is a top energy food and definitely in my list of “Top Foods for Men”, partly because it has the best amino acid profile of all the grains! That means you can count it in, as a good protein source, and even better when you combine it with eggs, chicken or fish. It is full of vitamins and minerals too (especially B vitamins, calcium and magnesium). It is also high in potassium, just like bananas and avocadoes, all of which help to keep blood pressure within a healthy range. It is very low in fat and completely free of cholesterol, so a winner for those concerned about watching their dietary cholesterol intake.
Eggs
Eggs (preferably organic whenever possible) are a first-class source of protein (or what we term as having a high biological value), easy to cook, and an ideal way to begin a busy day. A high protein breakfast such as scrambled eggs on wholegrain toast balances blood sugar levels effectively and will certainly sustain you a lot longer than toast and jam. If you are concerned about the cholesterol content of eggs, limit your intake to 3 a week; otherwise there is no need to worry. Eggs are also rich in choline (vital for keeping your memory boys!!) and the carotenoids lutein and zeaxanthin… these are important to help prevent cataracts, as well as age-related macular degeneration, both of which lead to blindness.
Eggs really are easy to cook… hard-boil them, soft-boil them, poach them, scramble them - just try to avoid cooking them with excessive amounts of butter, cream or oil. Eggs Benedict should be a “once in a while treat”!
Oysters and other Seafood
Oysters are rich in the mineral zinc - commonly referred to as the fertility mineral! Oysters are famed for their reputation as an aphrodisiac, and I suppose it’s the high zinc content that gives this reputation some scientific basis? The fact is that oysters do contain an extraordinarily high amount of zinc - essential for sperm production and the development of the reproductive organs.
Oysters unfortunately are not to everyone’s taste, so, are there any other foods that could have a similar effect? Well, some are mentioned above (pumpkin seeds and sunflower seeds) but other excellent dietary sources of zinc include crab, most other shellfish, offal and wheatgerm, to name a few. I don’t think however that any of these have a reputation as true aphrodisiacs… offal or oysters?
Oysters for me I think…. With a glass of champagne preferably!
Garlic
Garlic has to be one of the most healthful and beneficial foods/herbs on the planet. Apparently it is one of the oldest cultivated plants, originating from central Asia. It is often talked about as being “anti-aging” as it is an excellent source of antioxidants. Antioxidants literally stop cells from “rusting” or ageing. We visibly see this process as wrinkles! Garlic is full of nutrients too such as B vitamins, calcium, sulphur and zinc, albeit in moderate amounts. But what garlic is most known for is it’s anti-bacterial benefits which are due to the active substance present in garlic, called allicin. This is why garlic is so helpful for colds and flu. Garlic supplements should contain the active substance (which remains stable when dried), as it is the properties of allicin that aid in maintaining a healthy heart and circulation, as well as possessing wonderful anti-microbial activity. Garlic acts as an anti-coagulant in the blood, which reduces the risk of strokes, and can help to destroy cancerous cells. The best way to eat garlic is RAW, minced, chopped or pulverised, and added to a salad dressing? However, I have to say that “garlic breath” isn’t very attractive!! Try chewing raw parsley after a heavily laced garlic meal. It works to neutralise the pungent smell of garlic as the chlorophyll in parsley acts as a cleanser and neutraliser. The alternative is to take a garlic capsule daily.
Avocados
Avocados, I think, feel a bit like butter on the tongue, but have a nutty flavour? In fact, Spanish sailors called them “midshipman’s butter” because they used them as a substitute for butter on long sea voyages. Avocados contain good amounts of B vitamins, including folate, and are one of the few fruits that contain vitamin E… an important fat-soluble antioxidant. Vitamin E is necessary for converting cholesterol into male sex hormones, and Vitamin E deficiency can induce fertility in both sexes by causing damage to the reproductive tissues. SO all you guys out there… a regular portion of avocado in the diet, with a handful of sunflower seeds and pumpkin seeds (also high in “E”) wouldn’t go a miss in your quest for optimal health!
Surprising to some maybe, but avocados contain twice as much potassium as bananas do and are an excellent source of the phytochemical lutein… also found in leafy green vegetables, and a key nutrient for improving eye health. Like olive oil, avocados provide good, monounsaturated fat, which is crucial to lowering LDL cholesterol. When testing an “avo” for ripeness, give it a gentle squeeze - a ripe fruit will leave a finger or thumbprint. To eat avocados, carefully cut lengthways and prize away from the stone. Just scoop out the flesh and enjoy! Try mashing the green fruit with chopped tomatoes, lime or lemon juice, a little chopped fresh chilli and salt for a gorgeous guacamole. Mixing with ricotta cheese also makes a super low-fat healthy dip.
My childhood memory of eating avocados is mashed on fresh wholemeal bread and sprinkled with a little salt - delicious!
Apples and bananas
Apples are full of several powerful antioxidants including a compound called quercetin. Quercetin is known to be a very effective natural anti-histamine and works synergistically with another anti-histamine - Vitamin C. Hay fever sufferers find this combination very useful during the “allergy” season. You may find supplements available that often combine these with bromelain, a good anti-inflammatory. Apples are also high in the soluble fibre, pectin, helping to lower LDL cholesterol. So there must be some truth in the saying “An apple a day keeps the doctor away”? The best way to eat them is ripe, raw, and with the peel intact - don’t peel apples, as it is in the skin that you find the quercetin!
Bananas (like avocados) contain tons of potassium, magnesium and folate. Potassium helps fight high blood pressure and reduces the risk of strokes. A high fruit and veg diet should supply you with plenty of potassium. Folate is necessary for proper cell growth, and in lowering blood homocysteine - vital in the prevention of heart disease.
Berry fruits
Purple, dark red and blue berries are not only rich in vitamin C and are anti-ageing, but they can also be useful for gout sufferers. Gout is a very painful condition, and is the result uric acid being dumped in tissues - often in the big toe! It causes inflammation and pain, and can progress to joint degeneration and arthritis. Unfortunately too, it is often related to kidney problems, and there is an increased risk of kidney stones. Fruits such as blackberries and blueberries etc. can help due to the presence of antioxidants known as anthocyanins and proanthocyanins - these are what give them such a rich gorgeous colour. Better still, they are natural anti-inflammatories so can ease the pain of the inflammation. Gout sufferers also need to follow a low animal protein diet, cut down on alcohol, drink plenty of water and eat lots more colourful fruit and veg.
Oats
Oats are high in B vitamins and calcium, as well as both insoluble and soluble fibre. This means that not only are they nutritious, they can help to keep the bowels free from toxins - as well as helping the elimination of waste too!
The high soluble fibre content in oats is the reason why they’ve been shown to lower LDL cholesterol levels (the nasty cholesterol) when eaten on a regular basis. By including a bowl of porridge oats in your diet everyday, you will be doing something quite significant towards protecting yourself from heart disease. Another great source of soluble fibre in linseeds, so add a tablespoon to your bowl of oats in the morning. Whole organic oats are the best to go for!
Tips and recipes…
This recipe has been kindly compiled by Paul Clements. Paul is Jersey’s top male triathlete, Great Britain triathlon age group team member since 1999, European triathlon age group champion in 2000, Island Games Gold medallist 2001 and Bronze medallist 2003. He has just qualified for the Commonwealth Games, being held in Melbourne in March 2006.
Paul is passionate about healthy eating, and says his food and nutrition is quite simply his fuel for success!
His tip for healthy eating is to be well prepared, keeping a stock of vegetables in the fridge and fresh fruit in the fruit bowl - It is as simple as that!
This recipe is one of Paul’s favourite post-workout recovery meals.
Grilled wild salmon on a bed of sweet potato mash, with roast winter vegetables
Serves 2:
2 large fresh wild salmon steaks
French Dijon mustard
Ground black pepper
Two large sweet potatoes
1 tablespoon of extra virgin olive oil
2 parsnips
2 large carrots
1 bulb of fresh broccoli
1 red pepper
1 yellow pepper
1 leak
1 red onion
2 fresh garlic segments
1 small bag of kale
Chop the parsnips, carrots, broccoli, peppers, leak, onion and garlic into pieces. These can be as big or as large as you wish… cutting the carrots and parsnips length ways is my favourite. Place all the pieces in a bowl and drizzle over 1 tablespoon of extra virgin olive. Cover the bowl and shake to cover all the vegetables. Place the veggies on a baking tray and pop them into the oven at 200C for 30-35 mins. Whilst these are cooking chop the sweet potatoes into small pieces and place in a saucepan.
Cover the salmon steaks with a thin layer of Dijon mustard on both sides & sprinkle a little black pepper on top. Fill the kettle up and go and put your feet up or have that post gym shower for 15 mins. When the vegetables have 15-20 mins to go, open the oven and give them a quick stir. Put the kettle on to boil.
Now, put the steaks under a hot grill for 15 mins, turning them over mid-way through.
Poor the boiling water onto the sweet potatoes and simmer for 8-10 mins or until they’ve become soft. Put your plates on to warm.
When there is approximately 5 mins to go, sprinkle the kale over the roasted vegetables and pop back in the oven.
When the time is up, drain the water from the sweet potatoes and mash. Place the mash on the centre of your plates to form a bed for the salmon. Remove the salmon from the grill, and place on top of the potato. Now remove the roasted vegetables and arrange around the potato and salmon.
Add some garnish if you require, but most importantly, relax and enjoy your healthy post exercise winter meal!
Nutrition Facts:
Per serving: 780 calories, 50 g protein, 32 g fat (5 g saturated), 75 g carbohydrates.
This meal really is packed with nutrients, being rich in Selenium (50ug), calcium (300mg), folic acid (360ug), as well as being high in the antioxidants vitamin A, and C.
Lucy-Ann Prideaux MSc BSc RNutr is a registered Nutritionist, based in Sussex, England. Her consultancy “Simply Nutrition” attracts many individuals and sports people keen to improve their health, their athletic performance or to lose weight. She is passionate about food and nutrition, and is a keen writer.
Website: http://www.simply-nutrition.co.uk
Weblog: http://www.simplynutritionblog.typepad.com/
SUBSCRIBE to Simply Nutrition’s monthly newsletter and e-mail updates at http://www.simply-nutrition.co.uk
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