Tubal anastomoses by means of modified microsurgical technique

Twenty tubal anastomoses using a modified microsurgical procedure have been performed on 18 women who requested reversal of sterilization. Follow-up exceeded one year in 10 patients and was less than a year in five patients; three patients have deferred attempting pregnancy. Intrauterine pregnancy has been achieved in eight of the 10 patients who were followed up longer than one year; there have been five term deliveries, five abortions, one ectopic pregnancy and one patient was pregnant at the time of writing. The only pregnancies of three patients have terminated in abortions. Anastomotic dehiscence occurred in one patient, and tubal patency after a reanastomosis has been achieved, but she has failed to become pregnant as has one other patient with confirmed tubal patency. Tubal patency has been demonstrated in the three patients who have deferred pregnancy, and there has been one failure in the five patients who were followed up for less than a year. A second successful reanastomosis was performed in another patient in whom pelvic inflammatory disease followed an abortion which was performed in a country centre. Despite tubal patency, she also remains infertile. The possible reasons for failure and the abortions are discussed.