Abstract
Objectives: To evaluate the pregnancy and delivery rates of laparoscopic tubal reanastomosis.Study Design: From 2003 to 2013, 135 laparoscopic tubal reversals were performed according to the four stitch technique. The parameters studied, included positive pregnancy test, miscarriage, ectopic pregnancy, termination of pregnancy, term delivery, post-operative time to conception, post-operative hysterosalpingography, and spermogram.Results: From the 135 patients operated, 93 fulfilled the inclusion criteria. The age of patients varied from 27 to 47 years old. All ages combined, positive β-HCG blood sample rate was 75.3% (95% CI: 65.0–83.4%) and term delivery 52.7% (95%CI: 42.1–3.0%). The age-adjusted pregnancy and delivery rates were as follows: 27–35 y.o. (n = 23) 95.7% (95%CI: 76.0–99.8%) and 73.9% (95%CI: 51.3–88.9%),36–39 y.o. (n = 40) 77.5% (95%CI: 61.1–88.6%) and 47.5% (95%CI: 31.8–63.7%),40–42 y.o. (n = 19) 68.4% (95%CI: 43.5–86.4%) and 52.6% (95%CI: 29.5–74.8%),43–47 y.o. (n = 11) 36.4% (95%CI: 12.4–68.4%) and 27.3% (95%CI: 7.3–60.7%).Conclusions: In our series the pregnancy and delivery rates after laparoscopic reversal of tubal sterilization is estimated at 75.3 and 52.7%, respectively. For women with tubal sterilization and no other infertility factors, reanastomosis can restore anterior natural fertility related to age. Laparoscopic reversal should be proposed systematically to patients and performed by well-trained laparoscopists, avoiding potentially the inconvenient and adverse outcomes of an IVF treatment. Although, it may seem a more cost-effective technique compared to robotically assisted reversal, a prospective randomized trial could answer this question.
Highlights
Tubal sterilization is a commonly spread method of contraception worldwide
Spermogram normality was defined by the standard World Health Organization (WHO) classification and intermediate type when one pathological cumulative incidence seemed to drop and one would expect the plot to reach to a plateau, were the follow-up period adequately prolonged
The cumulative incidence of pregnancy according to time per age group is illustrated in Figure 2; it is interesting to observe that women of 36–39 years old and 40– 42 years old follow very similar paths
Summary
Tubal sterilization is a commonly spread method of contraception worldwide. Its use largely varies from one country to another, depending on socio-economic level, religion and medical facilities. According to the World Health Organization (WHO), tubal sterilization in Belgium is estimated at 8.4%, in Greece 5.8%, in China 28.7% and reaches even 47.4% in Dominican Republic [1]. Despite the definitive result of this procedure, many women express regret. Up to 14.3% or even 30% has been reported to ask for tubal reversal, with only 1.1% of women sterilized being operated [2]. Change of mind is usually due to change of marital status, loss of a child or change of attitude [3]. An important risk indicator for regret of sterilization is young age [4]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
