Fertility outcomes after reversal of tubal sterilisation

Abstract

Aim The aim of this study was to reveal the reasons why women request reversal of tubal sterilisation and to compare surgical techniques in terms of fertility outcomes.Methods This retrospective study included 36 patients, who underwent tubal reanastomosis surgery in our clinic between January 2008- June 2015. Analysis was made of laparoscopic tubal reanastomosis applied to 7 patients and of reanastomosis applied with laparotomy to 29 patients. For each patient, data were recorded on age at the time of sterilization, age at the time of reversal, body mass index, smoking use, alcohol use, pelvic surgery history, subfertility, additional diseases, known male infertility, demographics, hormone profiles, hysterosalpingograhy (HSG) results, applied sterilization methods, reversal methods, and the reasons for requesting tubal reversal. The fertility outcomes were evaluated.Results At the end of mean 2 years follow-up of patients, in the laparotomy group, 20 (69%) patients had not achieved pregnancy, 4 (13.8%) had abortus, 1 (3.4%) had an ectopic pregnancy and 4 (13.8%) patients had live births. In the laparoscopic group, pregnancy was not achieved in 5 patients (71.4%), 1 (%) was complicated with ectopic pregnancy, and 1 14.3%) had a live birth.Conclusion Before reversal of tubal sterilisation, a detailed patient history should be taken, the data of the sterilization operation should be accessed, and laparoscopic surgery must be presented to the patient as an option. When considering the probability of pregnancy, the patients’s age, BMI, additional diseases, and other factors that affect fertility must be taken into consideration. Although the number of cases was limited, the results of this study support the view that laparoscopic tubal reanastomosis is a safe and effective procedure.

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