Can tubal reversal be an alternative to IVF? Cohort study

Year 2023, , 14 - 17, 20.01.2023

Alev Esercan , Emre Ekmekci

https://doi.org/10.38053/acmj.1179603

Abstract

Introduction: Tubal reversal is the surgery done after tubal sterilization. Mostly, sterilization at a younger age or a new partner makes women request tubal reanastomosis. In the literature, pregnancy and ectopic pregnancy rates after tubal reversal is about 65% and 5.6%, respectively.
Material and Method: In our study, data from the files of patients who had tubal reversal operations between 2015-2021 years in Sanliurfa Training and Research Hospital were collected retrospectively. Demographic features, surgical and pregnancy outcome data of patients were collected. This study investigated the pregnancy rates and associated factors with pregnancy rates after tubal reanastomosis operations.
Results: In our study, 112 patients with tubal reversal operations were recorded. 25 out of 112 patients had spontaneous pregnancy after the tubal reversal operation. Age at a tubal reversal was a significantly important factor between a pregnant and non-pregnant group. According to age, below 40 years seems an ideal age factor for pregnancy. In our study, pregnancy rates were lower than in the literature.
Conclusion: Tubal reversal operation can be an alternative to IVF below 40 years of age.

Keywords

Pregnancy, sterilization, tubal reversal

References

• Nations U. World Contraceptive Use 2022 and Estimates and Projections of Family Planning Indicators 2022. Department of Economic and Social Affairs, Division P.
• Gordts S, Campo R, Puttemans P, Gordts S. Clinical factors determining pregnancy outcome after microsurgical tubal reanastomosis. Fertil Steril 2009; 92: 1198-202.
• Elci G, Elci E, Sayan S, Hanligil E. Is there any difference between pregnancy results after tubal reanastamosis performed laparotomically, laparoscopically, and robotically? Asian J Endosc Surg 2022; 15: 261-9.
• Gomel V, McComb PF. Microsurgery for tubal infertility. J Reprod Med 2006; 51: 177-84.
• van Seeters JAH, Chua SJ, Mol BWJ, Koks CAM. Tubal anastomosis after previous sterilization: a systematic review. Hum Reprod Update 2017; 23: 358-70.
• Hirshfeld-Cytron J, Winter J. Laparoscopic tubal reanastomosis versus in vitro fertilization: cost-based decision analysis. Am J Obstet Gynecol 2013; 209: 56.e1-6.
• Messinger LB, Alford CE, Csokmay JM, Henne MB, Mumford SL, Segars JH, et al. Cost and efficacy comparison of in vitro fertilization and tubal anastomosis for women after tubal ligation. Fertil Steril 2015; 104: 32-8.
• van de Water M, Bosteels J, De Sutter P, Weyers S. Laparoscopic non-microsurgical tubal reanastomosis: A retrospective cohort study. Eur J Contracept Reprod Health Care 2015; 20: 193-200.
• Boeckxstaens A, Devroey P, Collins J, Tournaye H. Getting pregnant after tubal sterilization: surgical reversal or IVF? Hum Reprod 2007; 22: 2660-4.
• Godin PA, Syrios K, Rege G, Demir S, Charitidou E, Wery O. Laparoscopic reversal of tubal sterilization; a retrospective study over 135 cases. Front Surg 2018; 5: 79.