Pregnancy Rate after Tubal Reanastomosis: A Case Presentation and Systematic Review

Abstract

laparotomy approach to identify the previously ligated fallopian tubes. Using a loupe, we performed resection on both proximal and distal ends of the dissected tubes. Interrupted sutures were done on the mesosalpinx, followed by four stitches on muscular layers at 6, 3, 9, and 12 o’clock positions. Tubal patency test was then performed to check the patency of both tubes. An irrigated methylene blue into both fimbriae tubae indicated the patency of both tubes. During the 12-month follow-up, our patient became pregnant and delivered spontaneously. tubes after previous sterilization. This procedure involves a loupe or microscope for magnifying the tubes during reanastomosis procedure. Minimally invasive laparoscopy or robotic-assisted surgery are other alternative ways available to perform tubal reanastomosis surgery. 3 The outcome and success rate following tubal reanastomosis differ among patients, indicating several factors may affect the outcome. This study presents one report of a successful procedure of tubal reanastomosis. We also discuss the possible factors to improve the success rate of tubal reanastomosis. Systematic literature searching was done from the MEDLINE database. Our We performed a al. Rate Tubal Reanastomosis: A Case Presentation Systematic Review. Infertil Tubal reanastomosis is an option to recanalize fallopian tubes after previous sterilization. Several factors may be important in defining the success rate afterwards. This paper aimed to describe our experience performing tubal reanastomosis, and discuss the fertility outcome through a systematic literature review. We successfully performed tubal reanastomosis that resulted in pregnancy within 1 year after the procedure. Microsurgical tubal reanastomosis was performed with four-stitch technique. In addition, we conducted systematic searching to describe the efficacy of tubal reanastomosis in reversing the fertility status. MEDLINE database was searched with According to our criteria and search protocol, 16 studies were found, including 8,584 subjects. Data of pregnancy rate of those studies were collected to determine a cumulative pregnancy rate. According to our systematic review, we found tubal reanastomosis may result in successful conception of 70.27% of patients. Moreover, microsurgical tubal reanastomosis has comparable outcome in comparison to minimal invasive surgical approach. Therefore, tubal reanastomosis with microsurgery may be provided to reverse fertility status in low-resource settings. Our results mainly impact on patients who underwent tubal sterilization but need a fertility reversal. Our shared technique may be used as an important insight for the surgical approach. More importantly, pregnancy rates from the systematic review may be used as evidence-based prediction number of pregnancies.