REVERSAL OF FEMALE STERILIZATION - OUTCOME OF 210 REFERRALS

Aims. To determine the outcome of request for reversal of sterilisatio n and to compare demographic and social factors of women who subsequen tly withdrew their request with those who proceeded with the reversal assessment and operation. Methods. Information relating to the sterili sation and regret intervals were sought from 210 women. Demographic an d social factors were recorded and the outcome of the reversal request determined. Patients who withdrew or were deferred/declined were comp ared on relevant factors with the group who proceeded to, or are still planning, the reversal operation. Results. Ninety-two (44%) withdrew before or during the assessment phase. Another 13 withdrew after lapar oscopy identified a poor prognosis. Three declared their intention not to conceive after they underwent the reversal operation. To date, 83 have had surgery with the cumulative intrauterine pregnancy rate at 1, 2 and 3 years being 0.46, 0.62 and 0.78 respectively. In comparing th ose women who proceeded and withdrew, there were no differences in mea n age at referral, age at sterilisation, the number of living children nor marital status. The regret interval prior to referral was signifi cantly longer in the women who proceeded (27.9 and 19.5 months respect ively, p=0.03). Those who were highly motivated in their reversal requ est were also more likely to proceed (p = 0.003). Conclusions. There i s a large dropout rate of women who seek a reversal of sterilisation. Women who regret sterilisation may have sought sterilisation as a solu tion to problems that were psychosocial rather than contraceptive in n ature. We stress the importance of counselling for both sterilisation and its reversal, since in the latter many developmental personality a nd relationship problems remain unresolved.