Fertility following reversal of female sterilization
Rachagan, S.P.; Jaafar, Y.
Medical Journal of Malaysia 48(2): 225-228
1993
ISSN/ISBN: 0300-5283 PMID: 8350801 Document Number: 333197
In Malaysia, 2 obstetrician-gynecologists reviewed the case notes of 26 women who had undergone sterilization reversal at the University Hospital in Kuala Lumpur to identify factors that affect the success rate of sterilization reversal. None of the women had ovulatory disorders. All their husbands had a sperm count that fell within the normal range. The follow-up periods after surgical sterilization varied from 2 to 15 years. 38.5% of the patients underwent sterilization between age 20 and 25. 34.6% requested sterilization reversal between ages 26 and 30. The oldest patient requesting sterilization reversal was 45 years old. The reasons for requesting sterilization reversal were remarriage (53.8%), wanted more children (26.9%), lost a child (15.4%), and psychologically disturbed (3.8%). 15 women had had a postpartum sterilization and 11 had had an interval sterilization. The leading sterilization method was Pomeroy method (57.7%). The intrauterine pregnancy rate was 38.5% (10 patients). The ectopic pregnancy rate was 7.7% (2 patients). 9 intrauterine pregnancies occurred in women who had undergone isthmic-isthmic anastomosis. The 2 ectopic pregnancies occurred in women who had undergone isthmic-ampullary anastomosis. 80% of the intrauterine pregnancies occurred in women whose interval between sterilization and reanastomosis was less than 5 years. These results show that women at high risk of requesting sterilization reversal are women less than 25 years old who have lost a child, who underwent postpartum sterilization, and who are in a poor or marginal marital situation. Physicians should properly counsel all patients, especially those in the high risk groups, before agreeing to performing sterilization. They should advise women requesting a sterilization during the postpartum period to consider interval sterilization.