TUBAL STERILIZATION REVERSAL: IS THERE ANY ROLE IN THIS MODERN ERA OF ART?

Objectives: To determine the clinical pregnancy rate and to evaluate the factors affecting pregnancy rate following tubal recanalization. Study Design: Descriptive case series. Sampling Technique: Consecutive sampling. Setting / Duration of Study: The study was conducted at Lady Willingdon Hospital Lahore, from January 2010 to March 2014. Methodology: Fifty nine women were included who underwent tubal reanastomosis at Lady Willingdon Hospital Lahore. Inclusion Criteria: Patients undergone tubal ligation, no other female cause of infertility, normal semen analysis. Surgical Procedure: Patients underwent tubal reanastomosis through laparotomy. 4-quadrant suture technique was used. Data Analysis: Data was collected and entered into SPSS version 20. Descriptive statistics were computed and differences between groups were assessed through Chi square test where it was required. P-value 0.05 was taken as statistically significant. Results: Out of 59 patients we could follow only 55 patients for clinical pregnancy as rest of 4 were lost for follow-up. Pregnancy rate, intrauterine ongoing pregnancy, miscarriage and ectopic pregnancy were the main outcome measures. Over all pregnancy rate was 34.5% (19/55), intrauterine pregnancy rate was 84.2% (16/19), term viable pregnancy was 68.8% (11/16). Spontaneous abortions were 31.3% (5/16) and ectopic pregnancy rate was 15.8% (3/19). Conclusions: The important prognostic factors for the success of tubal recanalization are age of the patient, sterilization/reversal interval, site of sterilization, method used for sterilization and length of the tube after reanastomosis. The technique is feasible, simple and less time consuming with good intrauterine pregnancy rate.