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Tubal Resection and Anastomosis I. Sterilization‐Reversal
Author(s) -
FRACOG Robert P. S. Jansen FRACP
Publication year - 1986
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.1986.tb01592.x
Subject(s) - medicine , fallopian tube , pregnancy , laparoscopy , sterilization (economics) , surgery , endometriosis , uterus , anastomosis , pregnancy rate , fertility , gynecology , population , genetics , environmental health , monetary economics , economics , foreign exchange market , biology , foreign exchange
Summary: Seventy‐seven women (median age 30 years, range 21 to 43) underwent microsurgical tubal resections and anastomoses for sterilization‐reversal. All patients had a laparoscopy between 8 and 21 days postoperatively to allow early diagnosis and treatment of adherences that had formed between tube and ovary or between adnexa and uterus or bowel. Follow‐up ranged from 1 to 21 months and outcome was assessed with life‐table methods. The cumulative probability of pregnancy was 63% at 6 months from surgery, 80% at 12 months and 87% at 18 months. Empirically, average fecundability, or monthly probability of pregnancy, was 13.6%; of 70 women followed‐up and not on contraception, 59 (84.3%) have in fact conceived. The data indicate that: (1) tube‐length, at least above 4 cm, has no discernible effect on Fallopian tube function when fimbrial access to the ovary is not compromised; (2) elapsed time between sterilization and reversal is irrelevant to subsequent likelihood of pregnancy; (3) deleterious effects of endometriosis on fertility can be overcome surgically, provided precautions are taken to prevent adnexal adhesions forming; and (4) reversals of bilateral partial salpingectomies are less likely to be followed by pregnancy than are other methods of tubal interruption.