Document Detail


Clinical factors determining pregnancy outcome after microsurgical tubal reanastomosis.
MedLine Citation:
PMID:  18930195     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Sylvie Gordts; Rudi Campo; Patrick Puttemans; Stephan Gordts
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Publication Detail:
Type:  Comparative Study; Journal Article; Validation Studies     Date:  2008-10-18
Journal Detail:
Title:  Fertility and sterility     Volume:  92     ISSN:  1556-5653     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-05     Completed Date:  2009-11-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1198-202     Citation Subset:  IM    
Affiliation:
Leuven Institute for Fertility and Embryology, Leuven, Belgium.
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MeSH Terms
Descriptor/Qualifier:
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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