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\t\t<\/p>\nRALEIGH, N.C. \u2014 It was her second time trying to reverse what was supposed to be irreversible. The first time, Maranda Bordelon saved up for the $1,500 deposit, then booked a surgery date a few months out, so she\u2019d have time to cobble together the remaining $4,500 she\u2019d need to undo her sterilization. But just before her appointment, her parents\u2019 house burned down, and she couldn\u2019t stomach not being there to help. The deposit was non-refundable. That was in 2020. This time, instead of seeing that same surgeon, a two-and-a-half-hour drive from her home in Marksville, La., she\u2019d picked a clinic six states and nearly a thousand miles away.<\/p>\n
It was Dr. Charles Monteith\u2019s website that convinced her: hundreds of pages of testimonials, newborn after newborn, fat-cheeked, wide-eyed, caught mid-giggle or mid-wail. Many of them wore T-shirts that said, \u201cI\u2019m a Monteith miracle.\u201d The families had come to Raleigh from everywhere, it seemed. Arizona, Iowa, Utah, Pennsylvania, Massachusetts, Florida. When they\u2019d arrived, the moms\u2019 fallopian tubes had been closed: burned or clamped or cut or obstructed with metal coils. When they\u2019d left, the tubes were reopened, ready for fertilization. It would cost $7,500, plus travel. Bordelon had started saving up again.<\/p>\n
\u201cWe\u2019re leaving here broke,\u201d said her fiance, Kaleb Gentry, with a hint of pride, when they finally arrived in November 2024. \u201cWe\u2019ve spent everything we had to do this.\u201d<\/p>\n
She was a nurse, he was a foundation driller, each one tattooed with the other\u2019s name\u00a0 \u2014 and here was Monteith himself, familiar from YouTube, same black scrubs, same gap-toothed smile, giving them his pre-op spiel. \u201cWhat makes you want a reversal?\u201d he asked.<\/p>\n
\u201cWe got together after I\u2019d already had my children,\u201d Bordelon said. She was 27. They were both from Marksville, a speck of a city where cotton had given way to corn and soy, the fields carved out of the bayou. They had mutual friends, and he\u2019d slid into her Facebook messages. She\u2019d joked she was nothing to be fixated on, she had bad credit and a bunch of kids. He\u2019d replied he had good credit and no kids. He took her bowling with four of his cousins. He seemed like such a catch, she wondered if he was a serial killer or something, why he was single.<\/p>\n
\u201cDid you look into IVF at all?\u201d Monteith asked.<\/p>\n
\u201cI did a little bit, but I\u2019d kind of rather do it the full natural way.\u201d<\/p>\n
\u201cI hear that a lot, \u2018the natural way,\u2019\u201d Monteith said. \u201cHaving sex is more fun than getting stuck with needles.\u201d Bordelon giggled. In some respects, theirs was a classic tubal ligation reversal story, the story Monteith heard most often: Tubes tied young, when she already had kids and thought she was done. Then she\u2019d gotten divorced, met someone new who had no kids of his own, realized maybe she wasn\u2019t as done as she thought.\u00a0<\/p>\n
\t\t\t\t\t<\/p>\n
\t\t\t\t\t\tHow doctors are pressuring sickle cell patients into unwanted sterilizations<\/a><\/p>\n But there was another reason she wanted this surgery, another reason IVF wouldn\u2019t do. Ever since she\u2019d had a segment of each fallopian tube removed, she\u2019d been living with terrible pain. It would start a week before her period and linger afterward, lasting the better part of a month. She thought it was appendicitis at first; it sent her to the emergency room. Then it just became her new, unlivable normal. She kept having to leave her nursing shifts at the psych hospital, curl into bed, and wait for pain meds to kick in.<\/p>\n Post-tubal ligation syndrome, as it\u2019s known online, is a lesser-known instance of a now-familiar curse: a set of symptoms debilitating enough to unravel lives but inexplicable enough for many doctors to doubt it\u2019s a syndrome at all. After all, tubal sterilization<\/a> is among <\/strong>the most common forms<\/a> of female contraception. Some 700,000 Americans<\/a> get one every year. Per the medical literature, as surgeries go, this one is safe.<\/p>\n Those with PTLS beg to differ \u2014 at least for some uncounted subset \u2014 and they point to their 15,000-member Facebook support group as evidence. The mismatch sends women on maddening pilgrimages in search of recognition and relief. The best remedy, many with PTLS say, is reversal: Almost like turning back the clock, reverting to your pre-sterilization self. In fact, the first time Bordelon had put a deposit down to have this procedure in Louisiana, she was a single mom with three small kids at home, not looking to have another; she\u2019d just wanted the symptoms to end.\u00a0<\/p>\n That odyssey can lead not only into the operating room, but also into a tug-of-war with mainstream medicine, which recently has drawn some \u2014 be it avidly or uneasily \u2014 into the data-distrusting orbit\u00a0of Robert F. Kennedy Jr.<\/p>\n Is there evidence for a post-tubal ligation syndrome?<\/p>\n A contested illness presents a catch-22. With data limited, definitions fuzzy, and causes uncertain, some doctors are unconvinced. But how to collect data when it\u2019s hard to define exactly what you\u2019re collecting data on? The strict stipulations and cutoffs that help make something studiable and diagnosable may well leave out some of the very patients who already feel brushed off. It\u2019s true of\u00a0long Covid, myalgic encephalomyelitis\/chronic fatigue syndrome, and fibromyalgia<\/a>, too. Each one comes with this secondary affliction: not just the symptoms themselves, but the rift between official medical knowledge and people\u2019s accounts of what\u2019s unfolding within their own bodies and lives.<\/p>\n For Amy Barnett, it began right after her tubal ligation, during the birth of her second child, with an electricity-like pain crackling from her belly into her legs. When she asked whether her surgery might\u2019ve sparked this, the nurse said no. Doctors told her everything looked normal. She wound up in a wheelchair, unable to walk even a few steps to the bathroom. Eventually, fed up with Barnett\u2019s mysterious disability, her OB-GYN refused to see her. She was accused of drug-seeking when she went to the ER.\u00a0<\/p>\n The only plausible explanation she could find came from Google. When she looked up her symptoms \u2014 she would count around 32 of them \u2014 she happened upon a blog about PTLS affiliated with a Dr. Vicki Hufnagel. This had to be what she had. Only later would Barnett learn that Hufnagel was an anti-hysterectomy crusader who had lost her medical license in the 1980s amid a storm of lawsuits, accused<\/a> of comparing herself to Galileo, botching procedures she claimed to have invented, and submitting fraudulent bills.<\/p>\n Hufnagel had denied those claims and sought, unsuccessfully, to get back her revoked credentials \u2014 but even decades after the fact, Barnett saw that any semblance of an association between Hufnagel and her own attempts to get her PTLS recognized would hurt her cause. She wanted the condition studied, legitimized, not further discredited. When she began setting up online support groups in 2011, and became a PTLS social worker of sorts, she was careful never to steer fellow sufferers toward anything Hufnagel-tinged. She knew that the outside world was already primed against them.<\/p>\n \u201cWhen you hear about it, you think, \u2018OK, these are a bunch of kooky women, they\u2019ve developed some sort of cult, and they\u2019re just completely against tubal ligation.\u2019 That\u2019s not true,\u201d Barnett said. \u201cI\u2019m all for being able to make an informed choice.\u201d<\/p>\n \t\t\t \t\t\t\t\t\t\u2018I was almost forced to do it\u2019: One sickle cell patient\u2019s story of sterilization, pressure, and regret<\/a><\/p>\n What doctors should tell sterilization-seeking patients about PTLS, though, is itself contested. They had to discuss risks \u2014 but where did responsible disclosures end and fearmongering begin? As early as 1951, there were statistical blips suggesting that some version of PTLS might be measurable in studies \u2014 but they were often eclipsed by findings suggesting it wasn\u2019t. A 1998 review<\/a> titled \u201cIs there any evidence for a post-tubal sterilization syndrome?\u201d reported a possible yes for women in their 20s who\u2019d previously had menstrual issues \u2014 but a no for women over 30. A big New England Journal of Medicine study<\/a> from 2000 found that women who\u2019d had tubal ligations described more menstrual irregularities than those whose partners had had vasectomies \u2014 but significantly fewer instances of pain and heavy bleeding. A few more papers, and some doctors considered the question settled: The data showed no consistent link between sterilization and these symptoms.<\/p>\n That depended on what sort of data, though. Sufferers couldn\u2019t help but see patterns in their stories \u2014 affecting only a small minority of women, perhaps, and so diluted in the wash of studies, but worth addressing. Even when researchers explicitly set out to address patients\u2019 concerns \u2014 to bridge the gap between doctors with expertise in study design and people with expertise in their own bodily experiences \u2014 the community still felt dismissed. Barnett served as an adviser on a 2021 study, but ended up alienated. \u201cUnfortunately, the scientists did not include most of the symptoms that we wanted to look at,\u201d she said. It was the same vicious cycle contested illnesses are often caught in, academic medicine reaching for stricter criteria than patient groups. When the study came out, Barnett distrusted the results.\u00a0<\/p>\n There was already plenty of distrust to go around, with doctors repeatedly telling those with PTLS that their illness was all in their heads, that they were depressed or suffering from personality disorders or merely exhausted. It was hard not to see, in such dismissals, a generalized shrug about women\u2019s pain, and with it, a kind of critique. Motherhood is a medical and moral battleground, its every detail attracting judgment with an almost magnetic pull, people judging you for having too many children or too few, for breastfeeding or for not breastfeeding, every parenting decision a referendum on your worthiness and character. When Stacey Underwood, a real estate agent in North Carolina, told her doctor about her symptoms, his diagnosis was a maladjustment to having five kids, his prescription for a babysitter. \u201cIt made me feel like my role as a mother was under attack, like I was not good enough,\u201d she said.<\/p>\n Some found in Barnett\u2019s Facebook group what mainstream medicine could not or would not provide. \u201cAmy was amazing. She would message me. She would talk to me, answer my questions,\u201d said Misty, who\u2019d found herself using a walker at 38 and bleeding out clots the size of golf balls, and spoke on condition that her last name not be used. \u201cI just felt like a vampire who finds other vampires at a convention.\u201d<\/p>\n Tubal ligation reversal, a \u2018dying art\u2019<\/p>\n Tubal ligation reversal sits on the outskirts of American medicine, in a weedy gray zone, not quite shunned by the establishment, but not quite part of it, either. The guidelines are clear: Sterilization must be considered permanent. Undoing it is sometimes possible but never certain. Some 65% of reversals result in pregnancies, a 2023 analysis found<\/a>, but the number can depend on age, health, and surgical methods used. For many, the success rates are moot. While ligation is typically covered by insurance, reversal almost never is, and thus is often unattainable. It suggests the judgy economics of just-desserts: You can change your mind, but you\u2019ll have to pay for it yourself.<\/p>\n Hospitals offer the procedure, but the overhead expenses mean it can cost in the tens of thousands of dollars. It\u2019s also become rarer since the advent of in vitro fertilization in the 1980s, which many doctors prefer. By siphoning out eggs with a needle through the vaginal wall, physicians can circumvent blocked tubes without surgery; by relocating reproduction to a lab dish, they gain more control over various sources of infertility, male or female. Some training programs no longer teach reversal at all. \u201cIt\u2019s a dying art,\u201d said Eliran Mor, a Los Angeles-area reproductive endocrinologist.<\/p>\n All this gives it a contrarian allure, creating a niche for businesses like Monteith\u2019s. He relishes his outsider status. He\u2019d spent his early career as a more traditional OB-GYN but eventually began to feel like a cog, and left to apprentice himself to an older reversal surgeon. When his mentor retired to open a medical spa, Monteith took over the practice.\u00a0<\/p>\n \t\t\t \t\t\t\t\t\tTo prevent ovarian cancers, fallopian tube removal is on the rise<\/a><\/p>\n That sense of being different from other doctors is an essential part of his spiel. The day before Bordelon\u2019s surgery, he pulled up his website to show her how to send in a baby pic if the operation were successful. \u201cYou get pregnant, you let us know,\u201d he said. \u201cUnder \u2018testimonials,\u2019 come down to \u2018patient reporting.\u2019\u201d He scrolled and clicked. \u201cThe reason I put all this on here is that a lot of doctors don\u2019t think this is possible, and they put the patients down.\u201d<\/p>\n By his estimation, post-tubal sterilization symptoms are the reason for only about 5% of the 600 or so reversals he performs every year. Another 10% are motivated both by those issues and the desire for another child. The vast majority just wanted another child. But even that largest group has, in Monteith\u2019s view, been alienated by mainstream doctors, who sometimes talk about medical decisions as if they took place in a sterile, mathematical realm, divorced from the tangled stories of people\u2019s lives.<\/p>\n \u201cMost infertility specialists just think of this as a way to get pregnant,\u201d he said. \u201cSo when they talk about IVF versus tubal reversal, they just throw out statistics. But those statistics are meaningless to a person who wants to undo a prior mistake.\u201d His work, he knew, was part physiology, part symbol.\u00a0<\/p>\n \u2018I never got to plan to be pregnant\u2019<\/p>\n Bordelon knew all about wanting a fresh start. She\u2019d had her first child at 16, her second at 18. Soon, she was married, and her husband whisked her off to Mississippi to take an internship as a welder. She had two more kids, one at 19, another at 20. She\u2019d tried all kinds of contraception \u2014 the pill, the patch, the shot, an IUD \u2014 but none had worked for her. Each time she\u2019d found out she was pregnant, the news didn\u2019t feel exciting. A tubal ligation seemed like the only option. She was far from home in a relationship that was foundering, her husband working nights. They hardly saw each other and had little to say when they did. \u201cWe were basically like roommates,\u201d she said.<\/p>\n When it appeared, her pelvic pain was layered onto all this isolation and heartache. Then, in 2020, her youngest died at 18 months old, of sudden infant death syndrome. His name was Hudson. Their love for him was what had kept Bordelon and her husband together; now, he was gone. They got divorced. Within a year, she was a working single mom, seeing specialists for a mysterious chronic illness, bringing her older kids to decorate their younger brother\u2019s headstone for Christmas and Valentine\u2019s and Mardi Gras.<\/p>\n Though she didn\u2019t know it at first, she represented a new life for Gentry, too. They\u2019d been dating for a few months when she found out about his meth addiction. They were in the car, in search of corn-on-the-cob fabric for her daughter to wear in the \u201cniblet pageant\u201d at the Bunkie Corn Festival. They\u2019d struck out at Hobby Lobby; she was using his phone to look up directions to Joann Fabric and Craft when she saw what looked like a message from a dealer.<\/p>\n What\u2019s this, she demanded.<\/p>\n He\u2019d been meaning to tell her. It had started when his first wife had gotten cancer. He\u2019d be up all night, caring for her, then head to the construction site in the morning, exhausted. A buddy handed him some speed to help. He\u2019d gotten hooked \u2014 and still was when he first started spending weekends at her house. He hid his meth pills in Tylenol bottles. But he swore he\u2019d been sober for a month, that she was the best thing that ever happened to him. He begged her not to throw him out.<\/p>\n It felt like a betrayal. She couldn\u2019t believe there had been drugs around her kids. Then again, her times with Gentry had been among her happiest. She loved watching him with her children, how he took them fishing and squirrel hunting on the bayou by their house, the pride he took in them. Plus, she had noticed a change in him recently, his disposition less irritable, his body filling out. Maybe he really had kicked his drug habit.\u00a0<\/p>\n At first, she brought drug tests home from work and made him pee in a cup. He did it willingly, almost joyously, excited to prove he was sober still. Eventually she stopped. All around were stories of people who\u2019d been lost or who\u2019d pulled themselves back from the brink. The memory of one buddy inked on Gentry\u2019s hand, a guy who\u2019d been sleepless for days on speed and died in a car crash at 21. Their pastor, who\u2019d managed to kick meth and find God.<\/p>\n Gentry was the one who first brought up the idea that they have another child, maybe two. Bordelon had already tried to get a reversal as PTLS treatment. A specialist she\u2019d seen more recently had suggested it as a possibility \u2014 and she felt a yearning for a baby, too. She thought about how all four of her pregnancies had been surprises, her mind kicking into a clear-eyed anxiety. \u201cI wanted the full experience,\u201d she told Monteith. \u201cI never got to plan to be pregnant. Getting excited to test positive is different than, like, \u2018uh-oh.\u2019\u201d<\/p>\n The sheer amount of effort they had to put in was a testament to how committed they felt. This time, it would be the opposite of unplanned. \u201cThe route that me and Kaleb took to have a baby means a lot more to me than just finding out I was pregnant,\u201d Bordelon said.\u00a0\u201cWe\u2019ve saved money, scheduled a surgery, traveled across the country to this random doctor\u2019s office in this random place.\u201d<\/p>\n How PTLS symptoms can remap someone\u2019s world<\/p>\n There\u2019s a Google doc that gets passed around the PTLS community to help people find these \u201crandom\u201d doctors \u2014 a crowdsourced cheat sheet for a hard-to-navigate realm. Some surgeons won\u2019t perform reversals unless the patient is planning to have a child. Some will remove clips from the fallopian tubes but won\u2019t look for them if they\u2019ve become dislodged and wound up somewhere else. One doctor in Tennessee will only do reversals for married women. It\u2019s a kind of TripAdvisor for those in search of a very specific sort of trip.<\/p>\n \u201cBelieves in PTLS,\u201d some entries say. Or: \u201cdoes NOT believe in PTLS.\u201d<\/p>\n \u00a0\u201cBELIEVES IN PTLS-per his website but denied it in the past-approach with caution.\u201d<\/p>\n \u201cWill accept patients with BMI over 40!\u201d<\/p>\n \u201cNoted to be caring and understanding of PTLS symptoms- DOES NOT PERFORM REVERSALS\u201d<\/p>\n Illness can remap your world. What was once a daily activity now requires a calculus about conserving energy. The professionals who might\u2019ve earned reflexive trust now seem hapless if not downright harmful. It can start with fallopian tubes and expand outward, to encompass everything.<\/p>\n For Barnett, what began with PTLS led to concerns about surgical clips, which case reports have found might spark an inflammatory response in a minority of people. She discovered her body contained them not only from her tubal ligation but also from previous gallbladder and thyroid surgeries. She flew to Raleigh for a reversal, to Austin for one clip removal operation, to Boston for another. She started another Facebook group and Google doc devoted to clip issues, advocating for surgeons to screen patients for metal sensitivities before any procedure. She wondered if PTLS might share some explanations with other contentious syndromes that seemed further afield but that were also hypothesized to stem from foreign substances in the body, such as breast implants, surgical meshes, or certain ingredients in vaccines. <\/p>\n Her illness influenced her thinking more generally, too. In the lack of discussion about PTLS before sterilization, she couldn\u2019t help but see the same erosion of informed consent that she saw in vaccine mandates. She wouldn\u2019t post about that in her Facebook group. There\u2019s a rule against \u201cpolitical, vaccine, or religious debates.\u201d Still, it shaped her personal politics.\u00a0<\/p>\n In 2024, you might say she was a single-issue voter, her issue being bodily autonomy. To her, Kamala Harris represented vaccine mandates, President Trump represented the overturning of Roe v. Wade. She couldn\u2019t stomach either one. She\u2019s a registered Republican who often votes Democrat, a woman whose religious beliefs disallowed abortion for herself but who knows there are obstetric scenarios unimaginable until you\u2019ve lived them. She cast her ballot for Robert F. Kennedy Jr. for president, knowing he couldn\u2019t win.<\/p>\n But once he became Trump\u2019s health secretary, her hope was tinged with unease. She liked his stance against artificial food dyes, his scrutiny of rare vaccine adverse events, his vow to fund research into the causes of autism. Yet some of his claims struck her as crazy. The myth that poppers, rather than HIV, caused AIDS, for instance. Plus, in allying himself with Trump, Kennedy had joined forces with the man who\u2019d helped end Roe and spark an uptick in sterilization \u2014 to Barnett, a double whammy of women losing agency over their own bodies.<\/p>\n \t\t\t \t\t\t\t\t\tAs MAHA turns 1, a fired-up movement is still figuring out how to fulfill its promises<\/a><\/p>\n In her apprehension about\u00a0Kennedy, it was hard not to hear echoes of her take on Vicki Hufnagel, the disgraced doctor whose websites helped Barnett to discover PTLS in the first place: a figure to be wary of, in spite of certain useful ideas. Here\u2019s a man seen as a misinformation machine by many physician groups, making headlines for swimming in sewage-contaminated waters, a lawyer who has no medical license to lose. Some PTLS sufferers hated him; others were too sick to pay much attention. \u201cOur community already faces intense skepticism from the medical system,\u201d Barnett said. \u201cThe last thing our advocacy needs is to be undermined by political assumptions or for members to feel alienated over differing views.\u201d<\/p>\n Yet doctors\u2019 skepticism about PTLS drew others to Kennedy. At first, Kenna Kerr took the pain medicines, muscle relaxers, and antidepressants her physicians prescribed. She didn\u2019t attribute her son\u2019s autism to vaccines, because \u201conly crazy people think that.\u201d\u00a0<\/p>\n \u201cI worked in the medical field. I believed in vaccination. I got flu shots. We made sure all of us did,\u201d she said. It was the reaction to her illness that converted her. \u201cWhen I brought up PTLS to one doctor after another, they told me there\u2019s no such thing. I pretty much had to stop talking to them because it\u2019s like, OK, you\u2019re getting me nowhere, you\u2019re getting me no help, you\u2019re pushing medication on me but I\u2019m not getting better, I\u2019m getting worse.\u201d<\/p>\n Her fallopian tubes had been removed entirely, so she wasn\u2019t a candidate for reversal, but she flew from Arizona to California to have the stumps reopened. Her symptoms dissipated \u2014 and she started to believe that Kennedy had a point in worrying about chemicals in the food supply and in embracing debunked notions about vaccines. She sobs at the link she sees between the immunizations she gave her children and her son\u2019s autism. \u201cWhat I went through with my sickness, how crap the treatment was through the medical system, it\u2019s like my eyes opened,\u201d she said. <\/p>\n In dismissing people\u2019s pain, American medicine has helped usher in a kind of defensive dismissal, patients brushing away the entire edifice that doctors represent. The medical literature is clear: Again and again, studies have shown that vaccines do not cause autism<\/a>. When PTLS patient Stacey Underwood was asked about all of that evidence, she said, \u201cI just think that a lot of doctors are closed-minded. I was discredited for years because of the symptoms that I was having.\u201d She believes that people with bad reactions to vaccines face the same disbelief. But if her symptoms weren\u2019t real, how was it possible that she could get a reversal and see the vast majority of them disappear?<\/p>\n \u2018I may not be able to repair this side\u2019<\/p>\n Monteith peered into Bordelon\u2019s abdominal cavity. Usually, he is focused but relaxed in the operating room, chatting, joking, like a performer backstage at a show. But now, his voice took on an edge of seriousness. \u201cShe has adhesions to this tube that are pretty dense. I may not be able to repair this side,\u201d he said.<\/p>\n He was about 30 minutes into her surgery. She was draped and anesthetized, the only part visible a tiny bit of skin framing a red hole. He\u2019d sliced through her belly, separating layers of fat and muscle, an assistant widening the sides of the incision with a sort of metallic shoehorn. The right tube had been easy enough. It looked a bit like an earthworm as he maneuvered it \u2014 at once robust and pliable, squishier than you might expect for the passageway where egg had met sperm, forming a single cell that had then traveled down into her uterus, becoming an embryo, and, eventually, a child.<\/p>\n He\u2019d found the two severed ends and snipped them open where they\u2019d scarred shut, inserting a temporary stent into one side to keep it wide as he worked. Then he\u2019d begun suturing \u2014 first, a stitch to hold the segments close, so that they could be sewn together as if merely mending a wound. He\u2019d tweezered out the stent and put the finishing touches on the seam. \u201cThe tube is repaired,\u201d he\u2019d announced. \u201cNow we just have to hope it heals open.\u201d\u00a0<\/p>\n Her left side was more complicated. The tube and uterus were webbed with stringy tissue, gleaming pinkish in the lights of the operating room. These were bits of the apron that covers the abdominal cavity, made sticky in the scarring after her four C-sections. \u201cLike wallpaper glued to a wall,\u201d Monteith said.<\/p>\n He touched the webbing with a gloved hand. \u201cI could take this down, but the deeper I go, the more chance we could have bleeding. I may get all this off, and find the tube is crap, so to speak, and I\u2019ve done it for no reason,\u201d he said. \u201cI\u2019m not trying to push it, we\u2019ve repaired the right tube, it\u2019s in really good shape.\u201d By his own count, he\u2019d only had to send one patient to the hospital because of complications in the last 10 years. He didn\u2019t want Bordelon to be his second.<\/p>\n \t\t\t\t\t \t\t\t\t\t \t\t\t\t\t\t\t\t\t\tSign up for Daily Recap<\/p>\n All the health and medical news you need today, in one email<\/p>\n He\u2019d had patients get pregnant after reconnecting only one tube. What that might mean for Bordelon\u2019s symptoms was hard to say. She\u2019d hardly talked about her pain in the pre-op appointment.<\/p>\n It didn\u2019t seem worth it. He\u2019d just made the announcement to the team, so they could amend the operative note, to specify that the surgery was no longer bilateral \u2014 \u201cI\u2019m not going to repair the left side. So this is going to be a right tubo-tubal anastomosis\u201d \u2014 when he slipped a finger under the mat of pinkish stuff. Maybe it wasn\u2019t as bad as he\u2019d thought. In fact, that was something he could safely cut. He started in, the electrical scalpel giving off the strange plasticky smell of burnt flesh.<\/p>\n He began to chat again. \u201cThis helps restore her sense of fertility and of being a woman,\u201d he said, as he reached deep inside her abdomen with pincers, threading sutures in and out, in and out. \u201cTrying to have a child with him the natural way, as opposed to IVF, which is definitely more of a \u2014\u201d<\/p>\n He stopped himself. \u201cWell, this is a process. I mean, this is surgery. I\u2019m not kidding anybody.\u201d<\/p>\n His suturing was nearly done. \u201cStent\u2019s out,\u201d he said, and the whole team answered in a chorus, \u201cStent\u2019s out,\u201d their way of check-listing every piece that went in, to make sure nothing foreign got accidentally left inside her body. He pulled taut a few last, delicate stitches \u2014 fine as the hairs on your forearm, the difference between a severed tube and, hopefully, a functional one \u2014 and then was ready to start closing her up.<\/p>\n Can tubal reversal help with symptoms after sterilization?<\/p>\n Would this work? In terms of restoring her fertility, the answer was uncertain, but the uncertainty had been officially clocked, pregnancy and live birth rates tabulated, separated out by age and sterilization method and reversal technique, bounded with error bars \u2014 the predictable unpredictability that medical science is built on. In terms of treating her pain, the uncertainty was anecdotal. Of the PTLS Facebook group members who receive reversals, Barnett said, \u201cI don\u2019t have any data to back this up, but if I were to give it a number, I would say 98% of them either improve completely or vastly improve \u2014 more than half of their symptoms go away.\u201d<\/p>\n Why this might be was as mysterious as the biology of PTLS itself. Different phenomena might be at play in different bodies, but could present in a similar way. \u201cWe know so little about pain, and it can be so multifactorial, especially in the pelvis, where there\u2019s a lot going on, and women\u2019s pelvic pain is just such an understudied thing,\u201d said Kavita Arora, an OB-GYN at the University of North Carolina and a sterilization researcher.\u00a0<\/p>\n To her, some of that pain might have to do with women stopping birth control and their periods returning after a long hiatus. Barnett, though, points out that many with PTLS weren\u2019t on birth control. Some scientists have wondered whether sterilization might disrupt tiny blood vessels, shifting both blood flow to the ovary and its production of hormones. But the data are mixed, with some studies suggesting there is an impact and others suggesting there isn\u2019t. Why yet more surgery might help is unclear.<\/p>\n Or it might have to do with what is known as retrograde menstruation: the idea that during menstruation, when blood flows out of the uterus through the cervix and vagina, some also goes through the passage of the fallopian tubes and out into the pelvic cavity. \u201cWhen those passageways are blocked, it makes sense that there\u2019s probably some pain and cramping there,\u201d said Arora.\u00a0<\/p>\n Then again, in about half of Monteith\u2019s patients who report these symptoms, he sees the tubal ligation site studded with buckshot-like dark patches: a classic sign of endometriosis. It\u2019s a common and mysterious diagnosis, often thought to be caused by retrograde menstruation, those bits of blood and uterine debris triggering inflammation and terrible pain. In theory, blocking retrograde menstruation could help prevent this \u2014 but it\u2019s possible that in some cases, something about sterilization might open an accidental fistula, a fissure in the uterine wall, allowing that tissue to escape and settle where Monteith finds it on reversal. But endometriosis wasn\u2019t present in everyone. Bordelon, for instance, had none.\u00a0<\/p>\n Ditto for surgical clips. A rare inflammatory backlash might explain some aspect of reversal: Removing the object the body\u2019s reacting to might truncate the reaction. But why then would someone like Bordelon, whose tubes had been severed \u2014 no clips involved \u2014 experience PTLS, too? And why would those who\u2019d had their clips removed but not reversals find less relief than those who\u2019d gotten both, as Barnett has observed in her group?<\/p>\n For some patients, the symbolism of reversal is explanation enough, the rejoining of what has been severed. Some doctors, meanwhile, couldn\u2019t help but wonder whether the placebo effect was sometimes involved. The literature describes a strange phenomenon: the more intensive a treatment, the better patients seem to feel. One study found that four daily sugar pills were associated with better ulcer healing than two. Injecting saline was better at treating migraine and hypertension than oral pseudo-medication. Sham surgery has been found to help with everything from torn knee cartilage to Parkinson\u2019s disease. This might be at play in some PTLS patients, the intensity of the surgery itself therapeutic. <\/p>\n Barnett rejects this idea. To her, it sounds dangerously close to labeling the syndrome psychosomatic. Yet those who study the brain circuitry involved in sham therapies disagree. \u201cThere\u2019s no question that patients with Parkinson\u2019s disease have a real illness,\u201d said Matthew Burke, a cognitive neurologist and placebo effect researcher at the University of Toronto, who emphasized that he has no expertise in gynecology or PTLS. \u201cBut Parkinson\u2019s patients are exquisitely placebo-responsive.\u201d<\/p>\n In Barnett\u2019s thinking, physicians don\u2019t need any more excuses for not studying PTLS. She\u2019s been dismayed to see the Trump administration slashing scientific funding: She wants scientists to keep delving into her condition, exploring its immunological, hormonal, and genetic characteristics. \u201cI challenge them to look at our group specifically. This could be a great pool to figure out some questions that we\u2019ve not ever had the answers to,\u201d she said.\u00a0<\/p>\n Even those who in some ways are aligned don\u2019t see eye to eye on everything. Monteith, whom Barnett considers an ally, isn\u2019t sure about describing this group of patients as having a \u201csyndrome.\u201d That they have symptoms, however, is uncontroversial; to pretend otherwise feels untenable and unhelpful \u2014 a fact that you can\u2019t dispute. <\/p>\n![\"\"](\"https:\/\/www.europesays.com\/ie\/wp-content\/uploads\/2025\/09\/STAT0825_003-1024x683.jpg\")
Bordelon and her daughter make dinner and dessert together in their kitchen.Emily Kask for STAT<\/p>\n![\"\"](\"https:\/\/www.europesays.com\/ie\/wp-content\/uploads\/2025\/09\/CCHeroImage-P6-1-768x432.jpg\")
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<\/a>Bordelon shows a tattoo memorializing her son.Emily Kask for STAT<\/p>\n![\"\"](\"https:\/\/www.europesays.com\/ie\/wp-content\/uploads\/2025\/09\/STAT0825_049-1024x1536.jpg\")
<\/a>Bordelon\u2019s tattoo for Gentry.Emily Kask for STAT<\/p>\n![\"\"](\"https:\/\/www.europesays.com\/ie\/wp-content\/uploads\/2025\/09\/STAT0825_028-1024x683.jpg\")
The family prays before dinner together.Emily Kask for STAT<\/p>\n![\"\"](\"https:\/\/www.europesays.com\/ie\/wp-content\/uploads\/2025\/09\/STAT_MAHA_checkup_f2_3000-768x432.jpg\")
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Charles Monteith performs a reversal surgery.Eric Boodman\/STAT<\/p>\n![\"\"\/](\"https:\/\/www.statnews.com\/wp-content\/themes\/stat\/images\/article-new\/envelope-open.svg\")
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<\/a>Gentry and Bordelon at their home in Marksville.Emily Kask for STAT<\/p>\n
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<\/a>Bordelon holds up an ultrasound of her expected twins.Emily Kask for STAT<\/p>\n