A Study of Tubal Recanalization in Era of ART (Assisted Reproduction Technology) QC01-QC03
Dr. Sowmya Koteshwar,
No 761, E&F block, Kuvempunagar, Mysore, Karnataka-570023, India.
E-mail : email@example.com
Introduction: Tubectomy remains one of the most popular methods of permanent contraception in developing countries. But about 10% of them regret their decision and 1% want to restore their fertility. Out of many options open method of tubal recanalisation is one of the method of restoring fertility.
Aim: Primary objective was to analyse whether open tubal recanalization is a feasible option for those planning to conceive after tubectomy. Secondary objective was to evaluate the pregnancy rate and analyse the various factors affecting pregnancy rate after tubal recanalization.
Materials and Methods: A prospective study, follow-up of 2 year in patients treated with tubal recanalization during 2012-2013 at tertiary teaching hospital. 10 women underwent tubal recanalization procedure. Open surgery was done and the principles of microsurgery were followed meticulously throughout the procedure. S tatistical Analysis: All statistical analyses were performed using SPSS for Windows version 17.0 (SPSS Inc., Chicago, IL, USA). Data were expressed as means, medians, standard deviations, and percentages. We used Student's t-test to compare group means and Fisher-exact test to compare proportions. A p-value of <0.05 was considered significant.
Results: Out of 10 women who went recanalization an overall 50% pregnancy rate was achieved. All pregnancies occurred within 1 year of procedure. When previous sterilisation was done by laparoscopic route, after reversal all of them (100%) conceived while in those sterilised by Pomeroys method the pregnancy rate after reversal was only 16.6%. Following reversal pregnancy was stastically more significant in those with final tubal length of >5cm (p=0.04) and in those with Isthmo-Isthmic type of anastomosis .
Conclusion: Open tubal recanalisation remains a feasible option for those planning pregnancy after tubectomy. The important factors for determining the success of operation were age of the patient, time interval between sterilization and reversal, site of ligation, method used for previous ligation and the remaining length of the tube after recanalisation.