Reversal of Female Sterilization an Evaluation of 49 Cases at Maharaj Nakorn Chiang Mai Hospital

Abstract

Forty-nine patients underwent reversal of tubal sterilization between December 1981 and October 1991. The average age was 32.3 + 3.6 years, mean parity was 2.2 + 0.6 and mean duration from sterilization to reversal was 76.9 + 42.3 months. Reasons for requesting reversal were a change in marital status, desire for more children and loss of a child. The most common site of anastomosis was isthmic-ampulla, followed by ampulla-ampulla. 

The mean duration of follow-up was 21.1 +20.2 months. During this period 37 pregnancies occurred in 30 patients giving a crude pregnancy rate of 61.2%. Ectopic pregnancy occurred in 13.5% and abortion in 24.4%. Twenty patients delivered at least one living child giving a take-home pregnancy rate of 40.8%. To account for incomplete and variable follow-up, life-table analysis was performed yielding cumulative pregnancy rates of 30.6%, 45.9% and 80.8% respectively at 12, 24 and 36 months after operation. Prognostic factors that may affect the pregnancy rate were studied in stepwise survival analysis with covariates (Cox Model). Only operative time, dextran use, location of anastomosis and age of the patients were found to significantly predict success after reversal. (Thai J Obstet Gynaecol 1994;6:23-32)