Microsurgical reversal of female sterilization: a reappraisal
Gomel, V.
Fertility and Sterility 33(6): 587-597
1980
ISSN/ISBN: 0015-0282 PMID: 7380045 DOI: 10.1016/s0015-0282(16)44769-2Document Number: 447429
The role of microsurgery in reversal of sterilization has been reassessed and 118 cases over a 10-year period reviewed. Their ages ranged between 22 and 43 years of age and the interval between sterilization and request for reversal varied from 1 week to 16 years. The technical variations for tubo-tubal anastomosis necessitated by the condition of the oviducts have been outlined in detail. All 118 cases were included in the analysis without requirement for a minimal postoperative trial period. The 2 most prominent reasons for reversal request were a change in marital status (63%) and crib death (17%). 76 of these 118 cases achieved 1 or more intrauterine pregnancies. There was 1 ectopic gestation. No significant complications were reported. 47 patients, reported earlier, were resurveyed. They had had a minimal postoperative trial period of 18 months. The mean interval between reconstruction of tubes and subsequent pregnancy was 10.2 months. The longest interval was 40 months. 38 (80.8%) had achieved 1 or more term pregnancies or were in the latter 1/2 of a normally progressing pregnancy. An inverse relationship was noted between the total length of the reconstructed oviducts and the occurrence of pregnancy. With oviducts that were longer than 6 cm, most of the pregnancies occurred within 5 cycles following the reconstructive surgery. For those patients who conceived during the 1st postoperative cycle, their oviducts measured 5 cm or longer.