| Clinical factors determining pregnancy outcome after microsurgical tubal reanastomosis. | |
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MedLine Citation:
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PMID: 18930195 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate pregnancy rates after tubal microsurgical anastomosis. DESIGN: Retrospective study. SETTING: Private tertiary care center. PATIENT(S): Two hundred sixty-one women undergoing tubal microsurgical anastomosis. INTERVENTION(S): Tubal anastomoses were performed by minilaparotomy using microsurgical principles and approximating proximal and distal tubal ends in a two-layer technique with 8-0 ethylon. MAIN OUTCOME MEASURE(S): Pregnancy outcome was analyzed for the technique of sterilization, location of anastomosis, tubal length, age, and semen parameters. RESULT(S): After exclusion of 89 patients lost to follow-up (34%) and 8 who did not attempt to conceive, 164 of the 261 patients were analyzed.The overall intrauterine pregnancy rate was 72.5%, with a miscarriage rate of 18% and a tubal pregnancy rate of 7.7%. Related to age, the cumulative intrauterine pregnancy rate was, respectively, 81%, 67%, 50%, and 12.5% for patients <36, 36-40, 40-43, and >43 years. Mean time to pregnancy was respectively 6.9, 6.2, and 12.7 months, respectively, for patients aged <36, 36-39, and 40-43 years According to the type of sterilization, intrauterine pregnancies occurred in 72% after ring sterilization, 78% after clip sterilization, 68% after coagulation, and 67% after Pomeroy sterilization. Intrauterine pregnancies and ectopic pregnancies, respectively, occurred in 80% and 3.4% in the isthmo-isthmic, 63% and 18% in the isthmo-ampullar, 75% and 8.3% in the isthmo-cornual, 100% and 0% in the ampullo-ampullar, and 60% and 0% in the ampullo-cornual anastomosis groups. Tubal length after anastomosis did not influence the pregnancy rate. In case of fertile sperm, the pregnancy rate was found to be 80%, and it decreased to 50% in case of subfertile semen. CONCLUSION(S): Our results clearly demonstrate the validity of tubal microsurgical anastomosis, establishing a quasinormalization of the fertility potential and offering the opportunity for a spontaneous conception. |
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Authors:
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Sylvie Gordts; Rudi Campo; Patrick Puttemans; Stephan Gordts |
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Publication Detail:
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Type: Comparative Study; Journal Article; Validation Studies Date: 2008-10-18 |
Journal Detail:
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Title: Fertility and sterility Volume: 92 ISSN: 1556-5653 ISO Abbreviation: Fertil. Steril. Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-10-05 Completed Date: 2009-11-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372772 Medline TA: Fertil Steril Country: United States |
Other Details:
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Languages: eng Pagination: 1198-202 Citation Subset: IM |
Affiliation:
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Leuven Institute for Fertility and Embryology, Leuven, Belgium. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Female Follow-Up Studies Humans Male Maternal Age Microsurgery / methods, rehabilitation, statistics & numerical data Pregnancy Pregnancy Outcome* / epidemiology Pregnancy Rate Retrospective Studies Semen Analysis Sterilization Reversal / methods, rehabilitation*, statistics & numerical data Sterilization, Reproductive / methods, rehabilitation |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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