Document Detail


Organ-preserving and reconstructive microsurgery of the fallopian tubes in tubal infertility: still an alternative to in vitro fertilization (IVF).
MedLine Citation:
PMID:  20195966     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Tubal infertility mostly results from infections. Conception only is possible through complex treatments (in vitro fertilization or surgery). Success cannot be guaranteed, even after repeated treatments. Unfortunately, many couples are not informed about the prospect for success of tubal reconstruction. Problems of in vitro fertilization are low pregnancy and birth rates of 28.4% and <20% respectively (Germany) and the high number of multiple pregnancies (21%). In this retrospective study 462 women with acquired tubal infertility and further 127 women after previous sterilization underwent microsurgical treatment (microsurgical adhesiolysis, anastomosis, fimbrioplasty, salpingostomy, and refertilization due to former sterilization). The main outcome measures are the pregnancy and birth rates following the microsurgical procedure. Pregnancy and birth rates of 43.4% and 29.2%, respectively, were higher than the outcomes post-single in vitro fertilization (abortion: 6.4%, extrauterine pregnancy: 7.9%). When reversal of sterilization was performed, pregnancy and birth rates were higher at 73% and 50.6%, respectively (abortion: 15.7%, extrauterine pregnancy: 6.7%). The advantages of reconstructive microsurgery over in vitro fertilization include the ideally permanent restoration of woman's ability to conceive naturally (repeated pregnancies are possible without further therapy), a high postoperative birth rate overall, and avoidance of multiple births. It is advisable to inform the patient about the objective possibility of reconstructive tubal surgery.
Authors:
Cordula Schippert; Ursula Hille; Christina Bassler; Philipp Soergel; Bettina Hollwitz; Guillermo José Garcia-Rocha
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-03-01
Journal Detail:
Title:  Journal of reconstructive microsurgery     Volume:  26     ISSN:  1098-8947     ISO Abbreviation:  J Reconstr Microsurg     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-05-25     Completed Date:  2010-10-08     Revised Date:  2011-02-16    
Medline Journal Info:
Nlm Unique ID:  8502670     Medline TA:  J Reconstr Microsurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  317-23     Citation Subset:  IM    
Copyright Information:
Thieme Medical Publishers.
Affiliation:
Department of Gynecology and Obstetrics, Division of Reproductive Medicine, Medical School of Hannover, Hannover, Germany. Schippert.Cordula@mh-hannover.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Cohort Studies
Fallopian Tubes / physiopathology,  surgery*
Female
Fertilization in Vitro / methods*
Follow-Up Studies
Germany
Humans
Infertility, Female / diagnosis,  etiology,  surgery*
Microsurgery / methods*
Middle Aged
Organ Preservation / methods
Pregnancy
Pregnancy Rate*
Reconstructive Surgical Procedures / methods
Retrospective Studies
Risk Assessment
Salpingostomy / methods
Sterilization Reversal / adverse effects,  methods
Sterilization, Tubal / adverse effects,  methods
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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