In vitro fertilisation versus tubal reanastomosis (sterilisation reversal) for subfertility after tubal sterilisation.

BACKGROUND

Tubal sterilisation is the most popular contraceptive method in the world. Approximately 138 million women of reproductive age have had tubal sterilisation and there is evidence that increasingly younger women are being sterilized. With such large numbers of women choosing this option of birth control, it is clear that even if a small percentage of women later regret the decision, large numbers of women will seek counselling regarding reversal from their physicians.

OBJECTIVES

To compare the efficacy of surgical tubal reanastomosis and in vitro fertilisation in terms of live birth rates. The morbidity and cost-effectiveness of both techniques were also to be compared.

SEARCH STRATEGY

The following databases were searched: Cochrane Menstrual Disorders and Subfertility Review Group Specialised Register, MEDLINE (1966 to 2005), EMBASE (1980 to 2005), and other electronic databases. We handsearched the reference lists of trials, reviews and relevant textbooks; searched abstracts from relevant conferences, and personally communicated with experts in the field.

SELECTION CRITERIA

Randomised and quasi-randomised trials comparing surgical reversal of tubal sterilisation with in vitro fertilisation (IVF). The method of allocation will be assessed and results subgrouped according to whether the trials were randomised or quasi-randomised.

DATA COLLECTION AND ANALYSIS

No trials were found that met the selection criteria.

MAIN RESULTS

No data exist on which to report.

AUTHORS' CONCLUSIONS: There is a need for well-designed controlled clinical trials to compare the efficacy and safety of surgical reversal of tubal sterilisation and IVF in restoring fertility in women seeking pregnancy following tubal sterilisation.