Our Fertility Surgery Services

Understanding Tubal Ligation Reversal Surgery

Tubal Ligation Reversal Surgery (TLRS) offers a beacon of hope for women who wish to regain their fertility after undergoing tubal ligation. This procedure has the potential to significantly restore natural fertility, opening the door to the possibility of pregnancy.

Endorsed by the American Society for Reproductive Medicine (ASRM), tubal reanastomosis stands out as a highly effective method for reversing tubal sterilization. The ASRM advocates for this surgery as a preferable option to in-vitro fertilization (IVF), highlighting its superior cumulative pregnancy rates and cost-effectiveness, even for women aged 40 and above. This support underscores the procedure’s viability and success in offering women a path back to natural conception.

Premier Facilities

Our clinics in Beverly Hills and Marina Del Rey, California, are more than just medical centers; they are state-of-the-art havens where advanced technology meets comfort. Designed to provide the best in surgical care, our facilities ensure your journey is supported by the latest advancements in tubal reversal procedures.


The crucial point to understand is that the fallopian tubes can be smaller than 1/10th of an inch in diameter, necessitating advanced technology and a surgical microscope for proper magnification and precision.
At our center, we utilize the most advanced surgical microscope, operated by double board-certified microsurgery expert. The most important take-home message is simply that.

The primary benefit of tubal reversal for our patients is its effectiveness. Nestled in vibrant Los Angeles, California, our center offers solutions that extend beyond mere effectiveness. With over 25 years of expertise, we specialize in a safe, cost-effective approach to tubal reversal surgery.

Under the care of our board-certified expert, patients undergo a minimally invasive procedure. This is performed through a small 5 cm (2 in) incision, utilizing specialized microsurgery techniques, enhancing success rates while minimizing postoperative discomfort and enabling a swift, smooth recovery. During the 40 to 70-minute procedure, a specialized tube is gently inserted into the uterus to allow the passage of dye through the fallopian tubes, confirming their patency and ensuring optimal outcomes.

Patients are discharged post-operatively the same day with pain management and antibiotics, supported by 24/7 access to their surgeon’s cell phone for any concerns.

While all surgeries carry inherent risks, our experience shows that immediate risks are minimal at our center. We provide comprehensive guidance to mitigate the risk of ectopic pregnancy, including early monitoring protocols. In the rare event of an ectopic pregnancy, our tailored approach, which includes medical intervention and close follow-up, ensures the utmost safety and care for our patients’ fertility journeys.

Serial hCG testing, individual pelvic ultrasound, and medical treatment with methotrexate can effectively treat most early ectopic pregnancies.

Expert Care Team

At the core of our practice is a team of seasoned professionals, each bringing years of expertise and a compassionate approach to patient care. We’re not just here to guide you through the process; we’re here to support you, offering personalized care that extends well beyond the surgery room, all with the goal of adding a new member to your beautiful family.

Unmatched Affordability

We understand the financial considerations that come with medical procedures, which is why we’re committed to providing the most cost-effective solutions without compromising on quality. Our promise is simple: the lowest possible prices for top-tier services. And if you find a lower offer elsewhere, we’re prepared to discuss options to meet or beat it. Experience exceptional care that’s within reach.

Complimentary Consultation

Begin your journey with a no-cost phone consultation, offering you personalized attention and evaluation from the start. This initial step is our way of ensuring you feel informed, valued, and understood, setting the foundation for a successful path to extending your family.

Fig. 1


Essure is a form of tubal occlusion. A hysteroscope ( a device that scopes inside of the uterus) is used to place two separate sterile metallic coils into each fallopian tube. They stimulate an inflammatory response and scar into the lining of the fallopian tube. This is how they occlude the fallopian tubes where they connect to the uterus. Essure was first approved by FDA for use in the United States in 2002.

In September 2015, the U.S. Food and Drug Administration (FDA) convened a meeting of the Obstetrics and Gynecology Advisory Board Committee to address the sudden increase of patient-reported adverse events surrounding Essure, a sterile coil that is inserted into the fallopian tube through hysteroscopy. After a review of the premarketing and postmarketing data and existing scientific literature, the FDA concluded there was insufficient evidence to remove the device from the market. However, the FDA did release a new guidance document requiring a black box warning for the device and ordered a new postmarketing study comparing Essure’s safety and efficacy with laparoscopic tubal sterilization. 

These were all due to extensive complications such as experienced complications such as:

  • pain
  • cramping
  • vaginal bleeding
  • pelvic or back discomfort
  • headaches
  • nausea and/or vomiting
  • Fatigue
  • Weight changes
  • Hair loss
  • Mood changes and depression
  • Allergy and hypersensitivity reactions
  • Joint or muscle pain
  • Muscle weakness

For these reasons, many patients desire to have their Essure coils removed from their body regardless of their future plans for pregnancy. Patients travel  nationally and internationally to come to our center to have their Essure coils removed or removed and reversed with a desire for future pregnancy. We have the most seasoned Essure removal and reversal experts at our center. Don’t wait! Get those coils out of your body.

Fig. 2

lower bikini line incision used for all reversal and removal procedures in our practice


Two choices exist.

  1. in-vitro fertilization (IVF)
  2. Essure removal and reversal

We specialize in the surgical removal of Essure coils and surgical reversal of Essure sterilization.  Isthmic –Interstitial ( two anatomical segments of the fallopian tube with the smallest caliber could be re-connected in expert hands utilizing a special microscope. Alternatively, re-implantation of the fallopian tubes into the uterus could also be done. Our experts perform this procedure under general anesthesia through a small 5 cm (2in) (fig 2) incision into your lower bikini line. We use a special microscope. This is to improve success rates and help reduce postoperative pain while improving fast and smooth postoperative recovery. Surgery is about 2 hours in uncomplicated cases. Patients go home the same day on painkillers and antibiotics. Patients will have 24-7 access directly to the surgeon’s cell phone for any and all concerns.


The literature lacks evidence-based articles to explore different techniques, success rates, complications, and outcome measurements. It is unclear what the effects of the Essure micro-insert devices are on IVF success rates and pregnancy outcomes.  Pregnancy with Essures in place may have its own risks. Maternity candidates should make themselves aware of the composition of the Essure micro-insert system and reasons for concern with pregnancy.
Our world-class clinics are in Beverly Our world-class clinics are in Los Angeles California. Our guests are referred to us from all over the world. We pride ourselves in providing the latest techniques in the hands of our world-renowned experts in a safe, cost-effective, compassionate, and private manner.


It should be done in expert hands. The coils should be removed in their entirety. They tend to get fragmented and broken if not properly handled. That could continue to give the patient the same symptoms and complications that we discussed above.


Through different approaches, i.e. abdominal, vaginal or laparoscopically assisted methods this is a straight forward outpatient surgery in the hands of our experts. This method does not involve removing of the ovaries that are the woman’s source of hormone production.

Complete bilateral Salpingectomy

This involves complete removal of both fallopian tubes. Must be done meticulously in expert hands to remove both Essures without fragmentation. This could be achieved through laparoscopic approach with 10 millimeters ( less than half of an inch) incisions. This procedure also helps reduce the chances of ovarian and fallopian tube cancers.

Partial bilateral salpingectomy

Only the segments of the fallopian tubes that contain the Essures would be removed. This could also be achieved through laparoscopic approach with 10 millimeters ( less than half of an inch) incisions.

Salpingostomy and Essure removal

This technique is used to just extract the Essure coils and their surrounding fibrotic scar tissues utilizing a special microscope. In expert hands, this method is more commonly used if Essure reversal and future pregnancy is desired.

Schedule your consultation now and explore our Tubal Ligation, Essure Reversal & Removal Services in Los Angeles!


Your Path to Motherhood:

Tubal Reversal Steps

Tubal reversal steps


Pre-Procedure Preparation


•Direct Consultation with Dr. Aram Bonni:
You’ll have a one-on-one consultation with Dr. Bonni, where you’ll receive personalized attention and care. From that moment on you will have 24/7 access to the doctor through his cell phone to discuss any and all concerns
directly with him.


•Comprehensive Medical Evaluation:
We conduct a thorough medical evaluation to ensure you’re a perfect candidate for the procedure, prioritizing your health and safety.


•Transparent Discussion:
Understand every aspect of the procedure as we discuss the risks, benefits, and set realistic expectations, so you feel confident and informed.


Surgical Procedure


•Comfort with General Anesthesia:
For your comfort, general anesthesia is administered, ensuring you feel no pain during the surgery.

•Advanced Surgical Techniques:
Our double board certified microsurgery expert surgeon utilizes cutting-edge techniques, including an advanced surgical microscope, ensuring precision and success. This is performed in a top-tier operating suite.

•Reconnecting the Fallopian Tubes:
The surgical team meticulously  reconnects and repairs your fallopian tubes, paving the way for restored fertility and your journey towards motherhood.



Post-Procedure Recovery


•Swift Recovery:
Thanks to our expert surgeons and the use of a small single  incision, recovery time is often quick, allowing you to get back to your daily life sooner.

•Comprehensive Post-Operative Care:
You’ll receive detailed instructions for post-operative care and follow-up appointments to ensure a smooth recovery. You will have 24/7 direct access to Dr. Bonni

•Returning to Normal Activities:
We guide you on resuming your normal activities and provide fertility monitoring to support your journey towards achieving pregnancy.


Success Rates and Expectations

Superior Success Rates:


Experience success rates at least 2-3 times better than IVF, offering you a significantly higher chance of achieving pregnancy.

Factors Influencing Success:

While success rates are exceptional, they depend on various factors, including:

-Available Number and Length of Tubes
-Previous Surgeries
-Body Mass Index (BMI)
-Use of Advanced Surgical Microscope
-Expertise of Our Surgeons

Realistic Expectations:

We’ll help you understand how these factors affect your individual chances and ensure you have realistic expectations throughout your journey.

Success Rates and Expectations

Natural Conception:

Enjoy the joy of natural conception and pregnancy without the need for assisted

Multiple Attempts, Multiple Children:

One procedure allows for multiple attempts at conception, giving you the opportunity to have multiple children.

Emotional and Psychological Benefits:

Restore your fertility and experience the emotional and psychological uplift that

Cost Comparison:

-IVF can cost $20,000 to $30,000 when all expenses are considered. This figure is for one cycle and usually about 2 months. In best candidates, pregnancy rates are between 25-30% per cycle. Chances are the cycle will be unsuccessful and repeat cycles and more payments are more common.

-TLRS is a more affordable option, at fraction of IVF cost.

- Long-Term Cost-Effectiveness: For couples planning multiple pregnancies, TLRS offers significant long-term savings and value, making it a cost-effective choice.

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