iTubal — An Honest Editorial Review

Most women who want to conceive after a tubal ligation are funneled straight toward IVF. Tubal ligation reversal — a surgical reconnection of the fallopian tubes — is a narrower, older path that still exists for the right candidate, and it requires a very specific kind of surgeon: an OB/GYN or pelvic surgeon trained in tubal microsurgery, not a reproductive endocrinologist. Among fertility clinics in California, iTubal is one of a handful of Los Angeles-area practices built entirely around this procedure, led by Dr. Aram Bonni, MD, FACOG, FACS.

The practice is narrow by design. Patients who reach iTubal are generally women who had their tubes tied (clips, rings, Falope rings, cautery, or Pomeroy-type ligation) or had Essure coils placed, and who now want to conceive naturally instead of cycling through IVF. Because of that focus, the conversation at iTubal is less about medication protocols and embryology and more about tubal length remaining, the original ligation technique, and whether microsurgical reanastomosis is technically feasible.

About the Practice

iTubal operates out of a Los Angeles surgical office on Gayley Avenue in Westwood, with additional consultation presence in Beverly Hills and Marina del Rey. Dr. Bonni is double board certified in Obstetrics and Gynecology and in Female Pelvic Medicine and Reconstructive Surgery (FPMRS), with fellowship training in urogynecology and pelvic surgery at Harbor-UCLA and UCLA Medical Center, plus additional cosmetic surgery fellowship training. He is a Fellow of the American College of Surgeons (FACS) and a Fellow of the American College of Obstetricians and Gynecologists (FACOG). The practice describes over 25 years of focused experience in tubal ligation reversal; specific case volume figures are not published.

Services

iTubal's scope is deliberately narrow:

• Tubal ligation reversal (tubal reanastomosis) — reconnection of previously ligated fallopian tubes, including clip, ring, Falope ring, and Pomeroy-type reversals
• Essure removal — surgical removal of Essure hysteroscopic sterilization coils
• Essure reversal — tubal reanastomosis following Essure removal when tubal segments can be reconstructed

The surgical approach described on the practice's website is microsurgical, performed under an operating microscope through a small incision (the practice cites roughly a 5 cm / 2 inch mini-laparotomy), with procedures typically lasting 40–70 minutes and same-day discharge. Microsurgical technique matters here because the fallopian tube lumen is roughly 1 mm in diameter, and tension-free, mucosa-to-mucosa reapproximation under magnification is what drives post-reversal patency and pregnancy outcomes.

iTubal does not perform IVF, egg retrievals, embryo transfers, or egg freezing — those require a separate REI and embryology lab.

Tubal Reversal vs. IVF

This is the real decision most iTubal patients are weighing, and it deserves an honest comparison rather than a sales pitch.

Tubal reversal is a one-time surgical cost, typically in the $6,000–$10,000 range nationally (iTubal does not publish pricing; verify directly). Once the tubes are open and patent, pregnancy is attempted naturally, month over month, and a single reversal can support multiple future pregnancies with no additional procedures. Candidacy depends heavily on the original ligation method — clips and rings generally leave more usable tube than extensive cautery — plus remaining tubal length, age, and partner sperm parameters.

IVF bypasses the tubes entirely. Per-cycle costs run roughly $15,000–$25,000 before medications; see IVF cost by state for the current California range. IVF tends to outperform reversal for patients over roughly 37–40, for those with diminished ovarian reserve, when male-factor infertility is present, or when the original ligation removed too much tubal length for reanastomosis. IVF also allows preimplantation genetic testing, which reversal does not.

Neither path is universally "better." For a 32-year-old with clip sterilization, a normal partner semen analysis, and no other fertility factors, reversal is often the lower-cost, longer-horizon choice. For a 41-year-old with low AMH and a history of cautery ligation, IVF — or donor eggs — is usually the more realistic route. Published CDC data on IVF outcomes is specific to IVF cycles; tubal reversal pregnancy rates come from surgical case series rather than a national registry, and how to read IVF success rates is still useful background when comparing clinic claims.

Patient Experience

Google reviews for iTubal sit at 5.0 across 15 ratings — a small but consistent sample. With volumes this low, individual reviews carry more weight than a star average, and the useful read is the content of the reviews themselves (surgical communication, post-op access, accurate expectation-setting about natural conception after reversal) rather than the rating.

The practice advertises 24/7 direct post-surgical access to Dr. Bonni by phone, which is unusual and worth verifying at consult.

Considering At-Home Insemination?

After a successful tubal reversal, the goal is timed natural conception — which is exactly the setting where some patients also layer in at-home insemination, particularly when the male partner is out of town during an ovulation window or when using a known donor. For couples with no identified male-factor infertility, at-home intracervical insemination (ICI) kits are a lower-cost, private option between clinic visits.

At-home insemination kits like those from MakeAMom come with step-by-step instructions designed for partner or donor sperm, arrive in plain discreet packaging, and are a one-time purchase that can be reused cycle over cycle until conception. They are not a replacement for clinic treatment when a known fertility barrier exists — and if tubal patency has not been confirmed post-reversal, insemination should wait until an HSG or equivalent imaging has documented open tubes.

Insurance and Cost in California

California's SB 729, signed in 2024, expanded fertility coverage for large-group and small-group plans and includes IVF among required benefits as the law phases in. Tubal ligation reversal, however, is an important exception to flag: it is almost always considered an elective procedure by US health insurers and is rarely covered, even in states with fertility mandates. Most iTubal patients pay cash or finance through third-party lenders; the practice advertises financing options. Background on state-level rules: fertility insurance mandates by state (2025).

Location, Hours, and Contact

Address: 1015 Gayley Ave, Suite 105, Los Angeles, CA 90024 Phone: (657) 888-3008 Hours: 9:00am–5:00pm (per practice website) Website: itubal.com

Frequently Asked Questions

Is tubal reversal or IVF more likely to work? It depends on age, the original ligation technique, remaining tubal length, and whether other fertility factors (male factor, ovarian reserve, endometriosis) are present. For younger patients with clip or ring sterilization and no other infertility diagnoses, published case series of tubal reversal report cumulative pregnancy rates competitive with IVF — often over 1–2 years of trying. For patients over roughly 37–40 or with additional fertility factors, IVF generally has higher per-cycle success and shorter time-to-pregnancy. A candid pre-op conversation about your specific ligation method is the most useful filter.

Will insurance cover tubal ligation reversal? Almost never. US insurers typically classify reversal as elective, even under state fertility mandates such as California's SB 729. Most patients pay out of pocket or finance. Essure removal is sometimes adjudicated differently when medical symptoms (pain, bleeding) are documented — ask your carrier directly.

Does iTubal perform IVF or embryo transfer? No. iTubal is a surgical tubal-reversal and Essure-removal practice. IVF, egg retrieval, and embryo transfer are performed by a reproductive endocrinologist (REI) and embryology lab at a separate fertility clinic. If reversal is not feasible or does not result in pregnancy, a referral to an IVF program is the next step.

Editorial note: Fertlo is an independent directory. See our editorial policy for how we research and update clinic profiles.