THE RISK OF PREGNANCY AFTER TUBAL-STERILIZATION - FINDINGS FROM THE US COLLABORATIVE REVIEW OF STERILIZATION

OBJECTIVE: Our purpose was to determine the risk of pregnancy after tu bal sterilization for common methods of tubal occlusion. STUDY DESIGN: A multicenter, prospective cohort study was conducted in U.S. medical centers. A total of 10,685 women who underwent tubal sterilization wa s followed up for 8 to 14 years. The risk of pregnancy was assessed by cumulative life-table probabilities and proportional hazards models. RESULTS: A total of 143 sterilization failures was identified. Cumulat ive 10-year probabilities of pregnancy were highest after clip sterili zation (36.5/1000 procedures) and lowest after unipolar coagulation (7 .5/1000) and postpartum partial salpingectomy (7.5/1000). The cumulati ve risk of pregnancy was highest among women sterilized at a young age with bipolar coagulation (54.3/1000) and clip application (52.1/1000) . CONCLUSIONS: Although tubal sterilization is highly effective, the r isk of sterilization failure is higher than generally reported. The ri sk persists for years after the procedure and varies by method of tuba l occlusion and age.