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Reproductive outcome after sterilization reversal in women of advanced reproductive age
M A Cohen1, P L Chang, M Uhler
1Department of Obstetrics and Gynecology, Columbia University College of Physicians & Surgeons, New York, New York 10032, USA.
Objective:
Our objective was to assess the clinical outcome of tubal reversal in women of advanced reproductive age.
Methods:
A multicenter retrospective chart review of 153 patients who underwent a tubal ligation reversal was carried out. Patients were evaluated according to age. All patients had documented ovulation and a partner with a normal semen analysis by WHO criteria. Outcome measures included rates of clinical pregnancy, ectopic pregnancy, spontaneous abortion, and live birth, and the time to conception.
Results:
Clinical pregnancy rates were significantly lower in women > or = 40 compared to younger groups. The time to conception was significantly shorter for women < 30 compared to women > or = 35. No pregnancies occurred in women > or = 42.
Conclusions:
Our data support the judicious use of sterilization reversal for infertile women with no male factor through their early forties. Women > or = 42 years should be especially counseled as to the very low success rates.