CUMULATIVE PREGNANCY ANALYSIS OF ONE-TUBE VERSUS 2-TUBE TUBAL ANASTOMOSIS

Objective: To determine the prognosis for pregnancy when tubal anastom osis can be performed on only one tube. Design: Prospective collection of demographic and clinical data. Setting: University medical center. Patient(s): One hundred twenty-six women undergoing elective steriliz ation reversal. Intervention(s): Sterilization reversal was performed by five reproductive endocrine surgeons. In 35 cases, only one tube co uld be treated surgically. In all cases, this was because of a previou s salpingectomy or inadequate distal tubal segment. Main Outcome Measu re(s): Cumulative probability of pregnancy in the two groups (one tube or two tubes) was analyzed by survival analysis and logistic regressi on. Survival curves were compared by log-rank testing. Result(s): Comp arison of survival curves revealed no difference between the logistic regression curves for probability of conception after anastomosis of o ne tube versus two tubes. Logistic regression revealed a similar cumul ative probability of conception with a two-tube (0.76) and a one-tube anastomosis (0.63). The monthly fecundity rates were 0.032 and 0.034 f or a two-tube and one-tube anastomosis, respectively. There were no di fferences between the groups with respect to age, gravidity, or parity . Virtually all pregnancies occurred within 2 years of surgery. Conclu sion(s): The prognosis for conception after one-tube anastomosis was t he same as for two-tube anastomosis. (C) 1997 by American Society for Reproductive Medicine.