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Fertility outcome after laparoscopic microsurgical tubal anastomosis
1Department of Obstetrics and Gynecology, CHA General Hospital, Seoul, Korea.
Objective:
To evaluate fertility outcome after laparoscopic microsurgical tubal anastomosis.
Design:
A retrospective study.
Setting:
Infertility Medical Center affiliated with University Medical School.
Patient(S):
Fifty-four patients, who had previously undergone tubal sterilization, seeking reversal.
Intervention(S):
Laparoscopic microsurgical tubal anastomosis was performed.
Main Outcome Measure(S):
Pregnancy success was assessed.
Result(S):
The overall pregnancy rate (PR) was 77.5% (38/49) and 29 patients already have delivered healthy offspring. Pregnancy in seven patients is ongoing and one case ended in abortion. There was one case of ectopic pregnancy. The pregnancy success according to the method of previous tubal sterilization was 16 of 24 with the Fallope-ring method, 14 of 15 in cases of cauterization, and 8 of 10 in patients in whom the Pomeroy technique was used. The pregnancy success according to the site of anastomosis was 3 of 4 in cornual-isthmic, 4 of 5 in isthmic-isthmic, 26 of 35 in isthmic-ampulla, 3 of 3 in cornual-ampulla, and 2 of 2 in ampulla-ampulla. The pregnancy success according to the tubal length was 5 of 7 at a length < or = 4 cm, 3 of 5 at 5 cm, 15 of 17 at 6 cm, and 15 of 20 at lengths > or = 7 cm.
Conclusion(S):
Considering the high PR in our minimal follow-up period of 12 months, laparoscopic microsurgical tubal anastomosis could be an alternative procedure to microsurgical laparotomy in patients requesting reversal of tubal sterilization.