Restoring fertility in women aged 40 years and older after tubal ligation: tubal anastomosis versus in vitro fertilization

Peregrine, Jamie; McGovern, Peter G.; Brady, Paula C.; Ginsburg, Elizabeth S.; Schlaff, William D.

doi:10.1016/j.fertnstert.2020.01.041

Cited by 2 publications

(4 citation statements)

References 38 publications

(49 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For women who desire fertility after tubal ligation, tubal anastomosis is the most cost‐effective method for most women younger than 41 years, and IVF for those aged 41 years or more 18 . Currently, for sterilized women aged 40 years or more, the best option is IVF or tubal anastomosis, which remains controversial 19,20 . Women with a history of tubal pregnancy have a lower fertility rate than sterilized women.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of laparoscopic tubal anastomosis in tubal occlusion patients after laparoscopic salpingostomy for tubal pregnancy

Xiang

Huang

et al. 2021

Intl J Gynecology & Obste

View full text Add to dashboard Cite

Objective To evaluate the effectiveness of laparoscopic tubal anastomosis for tubal occlusions associated with infertility in patients with previous laparoscopic salpingostomy for ectopic pregnancy. Methods This study is a retrospective analysis of the pregnancy outcomes of 173 infertile patients who underwent hysteroscopy and laparoscopic tubal anastomosis treatment between January 2013 and August 2018 in the Department of Reproductive Endocrinology in West China Second University Hospital of Sichuan University. All patients had a history of laparoscopic salpingostomy for tubal pregnancy. The primary outcomes were intrauterine pregnancy, ectopic pregnancy, and delivery rates. We further studied the associated factors that could influence the change in pregnancy status. Results The 24‐month cumulative clinical pregnancy rate of all patients was 107/173 (61.8%). The distribution of outcomes for the entire group of pregnancies was as follows: intrauterine pregnancy rate, 76/173 (43.9%); ectopic pregnancy rate, 31/173 (17.9%); delivery rate, 68/173 (39.3%); and miscarriage rate, 8/173 (4.6%). Age, type of anastomosis, hydrosalpinx, and endometrial polyps were significant prognostic factors in the multivariate model. Conclusion Laparoscopic tubal anastomosis is an effective treatment for tubal‐associated infertility due to previous laparoscopic salpingostomy for ectopic pregnancy, especially for women under 35 years of age.

show abstract

Section: Discussionmentioning

confidence: 99%

Effectiveness of laparoscopic tubal anastomosis in tubal occlusion patients after laparoscopic salpingostomy for tubal pregnancy

Xiang

Huang

et al. 2021

Intl J Gynecology & Obste

View full text Add to dashboard Cite

show abstract

“…[ 23 ] These results showed a higher pregnancy rate of over 50% after TA compared to the low pregnancy rate of IVF in ages 40 years and older. Although some groups have insisted that IVF is the best approach for restoring fertility in women over 40 after BTL,[ 23 ] these results suggest that TA may be considered as the first choice even in women over 40.…”

Section: W Hat To C Onsider When ...mentioning

confidence: 96%

“…support IVF as the best approach for posttubal ligation fertility, especially in women aged 40 years and older. [ 23 ] They explained the reason for this in the following five aspects.…”

Section: W Hy Is T Ubal R ...mentioning

confidence: 99%

“…The second is the surgical technique because great variations (50%~81%) in live birth rates have been reported depending on techniques used [ Table 1 ]. [ 10 23 ] Especially, perfect re-canalization of the two tubal segments is an essential factor for a successful pregnancy after TA. Various methods, including single-layer, two-layer, 1-stitch, 2-stitch, 3-stitch, or seromuscular fixation with microstaplers and biological glue, have been introduced.…”

Section: Easures To F Urther I ...mentioning

confidence: 99%

See 1 more Smart Citation

Where Microsurgical Tubal Reanastomosis Stands in the In vitro Fertilization Era

Moon,

Joo,

Kim

et al. 2024

Gynecology and Minimally Invasive Therapy

View full text Add to dashboard Cite

Among various options of contraception, bilateral tubal ligation (BTL) remains the most frequently used method for women worldwide even at present. However, up to 30% of those who undergo BTL eventually change their minds and wish to conceive again for a variety of reasons, such as a change in marital status or simply wanting more children. In this case, we can either approach it surgically with tubal re-anastomosis (TA) or by in vitro fertilization (IVF)-embryo transfer. Despite the many advantages of TA which lead the American Society of Reproductive Medicine Committee Opinion to recommend it as the primary choice of treatment in posttubal ligation infertility in 2012, IVF is widely being chosen as the first-line treatment nowadays. This study will review the efficacy of TA in various aspects, including pregnancy rate, cost-effectiveness, feasibility, and accessibility, based on review of the literature and our experience. Through this study, we intend to provide a basis for gynecologists to consider TA as the first option in women who wish to conceive again after BTL in this day and age of IVF.

show abstract

Restoring fertility in women aged 40 years and older after tubal ligation: tubal anastomosis versus in vitro fertilization

Abstract: Disclaimer: Authors for ''fertile battles'' are chosen to represent the full breadth of opinions. Individual authors, even within one side of the debate, do not necessarily agree with all viewpoints expressed.

Cited by 2 publications

References 38 publications

Effectiveness of laparoscopic tubal anastomosis in tubal occlusion patients after laparoscopic salpingostomy for tubal pregnancy

Effectiveness of laparoscopic tubal anastomosis in tubal occlusion patients after laparoscopic salpingostomy for tubal pregnancy

Where Microsurgical Tubal Reanastomosis Stands in the In vitro Fertilization Era

Contact Info

Product

Resources

About