Between October, 1989 and Dec., 1993. 278 consecutive patients had a reversal of tubal sterilization done by microsurgical technique at the infertility clinic of Il Sin Christian Hospital.
The patients' characteristics at the time of reversal were as follows; mean age 31.2 years (23~42), mean number of living children 0.6(0~3)and average interval between sterilization and reversal 6 years(1↓~15yrs).
The most common reason for tubal reversal was remarriage (45.3%), then the desire for a larger family (19.1%), the desire for a male child(18.3%), and the loss of children (15.5%)particularly male child.
91. 7% of previous sterilizations had been done by laparoscopic method (electric cautery 57.5%) and Yoon's ring 34.2%) and 6.1% bilateral tubal ligation done by cesarean section. There were only 2 cases of minilap and 1 case of postpartum tubal
ligation.
The main microsurgical operative procedures were isthmic-ampullary anastomosis (48.9%) and isthmic-isthmic anastomosis(37.4%).
Of the 202 patients who had microsurgical tubal reanastomosis between Oct. 1989 and Dec. 1992, 186 patients were followed up for 51 months. Of these, 164 patients became pregnant. Over all pregnancy rate 88.2%.
The pregnancy rate compared to the method of sterilization was 9.69%(p<0.001) in laparoscopic ring and 83.7% in cautery.
The pregnancy rate compared to the operative procedure was 93.7% in isthmic-isthmic and 86.6% isthmic-ampullary anastomosis.
The pregnancy rate compared to operation time in relation to menstrual phase was 85.2% in the proliferatory and 90.8% in the secretory phase.
The characteristics of the patient who became pregnant (N=164) were compared with those who didn't become pregnant (N=22). The pregnant group were 3 yrs younger, their tubes were 1.2 cm longer and had 1 year more shorter duration of
sterilization.
The outcomes of the 164 pregnancies were fullterm delivery in 117(71.4%), premature delivery 2 (1.2%), spontaneous abortion 23 (14%), induced abortion 8 (4.9%), ongoing pregnancy 9(5.5%) and 3 ectopic pregnancies (1.8%).
In these 3 ectopic cases, one had a subsequent intrauterine pregnancy after salpingectomy. All 3 cases had short postoperative tubal length and technically difficult in cornuo ampullary reanastomosis because of pathologic tubes.
Chi-square analysis of variance were performed with P<0.001 considered significant.
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