MICROSURGICAL REVERSAL OF TUBAL-STERILIZATION - A REPORT ON 1,118 CASES

Objective: To review and evaluate a series of patients who underwent m icrosurgical anastomosis of previously sterilized fallopian tubes. Des ign: Retrospective clinical study. Setting: Tertiary care academic cen ter. Patient(s): In the 134-month span from January 1980 to February 1 991, 1,118 women were evaluated for microsurgical reversal of previous tubal sterilization.Main Outcome Measure(s): Clinical characteristics of patients, pregnancy rates (PRs), and factors influencing the outco me. Result(s): Of 1,118 patients, 633 (56.6%) had been sterilized by l aparoscopic cautery. Loss of children was a leading reason for request ing tubal reversal. The mean interval between tubal sterilization and reversal was 51.9 months. Nine hundred twenty-two (82.5%) patients wer e followed up for >5 years. The overall PR after microsurgical tubal a nastomosis was 54.8% (505 of 922) with a delivery rate of 72.5% (366 o f 505), and the estimated anatomical success rate was 88.2% (814 of 92 2). There was no statistically significant difference in the PR or in the interval from tubal reversal to conception among the different ope rative procedure groups. In addition, no statistically significant dif ference in the PR was observed regardless of the postoperative tubal l ength. However, the interval from operation to pregnancy decreased sig nificantly as the postoperative tubal length increased. The pregnant p atients (n = 505) were younger and had a longer postoperative tube tha n the nonpregnant patients (n = 417); these differences were statistic ally significant. Conclusion(s): The pregnancy rate after microsurgica l reversal of tubal sterilization was not significantly correlated wit h the method and duration of sterilization, the operative procedure, o r the postoperative tubal length. (C) 1997 by American Society for Rep roductive Medicine.