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  • Title: Microsurgical reversal of female sterilization: the role of tubal length.
    Author: Silber SJ, Cohen R.
    Journal: Fertil Steril; 1980 Jun; 33(6):598-601. PubMed ID: 7380046.
    Abstract:
    A group of 25 women who had undergone tubal sterilization by a variety of techniques underwent microsurgical reanastomosis. The length of tube remaining and the segments of tube involved were carefully noted preoperatively, but were not used as a basis for selection of patients. The only criterion utilized for selecting patients was the presence of fimbriae on at least one side. In all patients, anatomical patency was achieved at surgery. Normal intrauterine pregnancy was directly related to tubal length. Of seven patients who had less than 3 cm of tube, none achieved pregnancy. Of seven patients who had 3 to 4 cm of tube, three achieved a normal intrauterine pregnancy. Among 11 patients who had over 4 cm of tube, all 11 achieved a normal intrauterine pregnancy. No significant difference in pregnancy rate was noted in women who had short segmants of ampulla so long as total tubal length was adequate. 25 women who had undergone tubal sterilization by a variety of techniques underwent microsurgical reanastomosis. It was the intention of this study to determine whether tubal length had any effect on the outlook for a successful pregnancy. The length of tube remaining and the segments of tube involved were carefully noted preoperatively, but were not used as a basis for selection of patients. The only criterion utilized for selecting patients was the presence of fimbriae on at least 1 side. Anatomical patency was achieved at surgery in all patients. 15 of the 25 patients (60%) achieved uterine pregnancy, with only 1 experiencing an ectopic pregnancy. Normal intrauterine pregnancy was directly related to tubal length. Of 7 patients who had less than 3 cm of tube, none achieved pregnancy. Of 7 patients who had 3-4 cm of tube, 3 achieved a normal intrauterine pregnancy. Among 11 patients who had more than 4 cm of tube, all achieved a normal intrauterine pregnancy. No significant difference in pregnancy rate was noted in women who had short segments of ampulla so long as total tubal length was adequate. It seems that as long as there are healthy fimbriae, microsurgical reanastomosis can restore tubal patency in all cases.
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