Microsurgical reversal of female mechanical sterilization techniques

Contraception. 1988 Jul;38(1):99-107. doi: 10.1016/0010-7824(88)90099-6.

Abstract

This study presents the patient characteristics, the reason for requesting a reversal operation, the surgical technique and pregnancy rates after a microsurgical reanastomosis following a mechanical (ring or clip) method of sterilization in 55 women. A corrected intrauterine pregnancy rate of 90% was obtained. Ectopic pregnancy occurred in 7% of the patients. Human female sterilization presently has a very high probability of being reversible on the condition that a careful mechanical sterilization has been performed.

PIP: Tubal sterilization has become the most common contraceptive method in women over 30, but an estimated 1% request reversal. Ring or clip tubal occlusion can be reversed microsurgically by removing the device and reanastomosing the fallopian tubes, usually at the isthmic segment. Of 55 patients whose tubal occlusion was surgically reversed, 90% became pregnant, and 33 had at least 1 child. The average time between reversal and conception was 6 months. The most serious risk after sterilization reversal is ectopic pregnancy (7%-21%). Spontaneous abortion rates are also high, but this may be due to the age of the women rather than to adverse effects of the surgery. Ring or clip sterilization has only a slightly higher failure rate than electrocoagulation, but it has the advantage of being successfully reversible.

MeSH terms

  • Abortion, Spontaneous / epidemiology
  • Abortion, Spontaneous / etiology
  • Adult
  • Age Factors
  • Anastomosis, Surgical
  • Fallopian Tubes / surgery
  • Female
  • Fertilization
  • Humans
  • Microsurgery* / adverse effects
  • Microsurgery* / methods
  • Pregnancy
  • Sterilization Reversal* / adverse effects
  • Sterilization Reversal* / methods
  • Sterilization, Tubal* / methods
  • Time Factors