Analysis of failure of microsurgical anastomosis after midsegment, non-coagulation tubal ligation

Improved prognosis of tubal anastomosis after midsegment tubal ligation is an important goal. A review of the causes of failure in 124 patients operated on from 1974 through 1978 is presented. All patients were ovulatory and had normal results in postcoital tests and semen analyses. All tubal ligations had been non-coagulation. The overall pregnancy rate was 74.2%. The follow-up period was 18 months to 5 years. Of the 32 failures, 6 had bilaterally occluded tubes, 3 had severe ovulatory dysfunction, in 12 the husbands had not previously fathered a child, and 11 were unexplained. In 20.7% of successes and in 37.5% of failures the husband had not previously fathered a child. This significant difference suggests an undefined male factor.