Tubal Sterilization Reversal: Is There Any Role in This Modern Era of Art?

Abstract

Objectives:To determine the clinical pregnancy rate and to evaluate the factors affecting pregnancy rate following tubal recanalization.Study Design:Descriptive case series.Sampling Technique:Consecutive sampling.Setting / Duration of Study:The study was conduc-ted at Lady Willingdon Hospital Lahore, from January 2010 to March 2014.Methodology:Fifty nine women were included who underwent tubal re-anastomosis at Lady Willingdon Hospital Lahore.Inclusion Criteria:Patients undergone tubal ligation, no other female cause of infertility, normal semen ana-lysis.Surgical Procedure:Patients underwent tubal re-anastomosis through laparotomy. 4-quadrant suture technique was used.Data Analysis:Data was collected and entered into SPSS version 20. Descriptive statistics were computed and differences between groups were assessed through Chi square test where it was required. P-value < 0.05 was taken as statistically significant.Results:Out of 59 patients we could follow only 55 patients for clinical pregnancy as rest of 4 were lost for follow-up. Pregnancy rate, intrauterine ongoing pregnancy, miscarriage and ectopic pregnancy were the main outcome measures. Over all pregnancy rate was 34.5% (19/55), intrauterine pregnancy rate was 84.2% (16/19), term viable pregnancy was 68.8% (11/16). Spontaneous abortions were 31.3% (5/16) and ectopic pregnancy rate was 15.8% (3/19).Conclusions:The important prognostic factors for the success of tubal recanalization are age of the patient, sterilization/reversal interval, site of sterilization, method used for sterilization and length of the tube after reanastomosis. The technique is feasible, simple and less time consuming with good intrauterine pregnancy rate. Key Words:Tubal reanastomosis, Tubal recanalization, Pregnancy rate, Tubal sterilization.

Comparative study of tubal patency by sonosalpingogram hysterosalpingography and diagnostic laparoscopy

“…In the present study, the sensitivity and specificity of the hysterosalpingography in detecting the tubal patency was 84% and 88.8% which is comparable to the studies conducted by Rizvi S et al and Diaz J et al where the sensitivity and specificity were 90.9 and 89.4, 77.4 and 80.2 respectively. 14,15 The positive and negative predictive values of hysterosalpingography in our study were 93.1 and 76.1%. This finding is similar to the findings of Foroozanfard et al and Sarkar MN et al where the positive and negative predictive values were 97.2 and 66.7%, 92 and 55% respectively.…”