Microsurgical reversal of female sterilization. Long-term follow-up of 117 cases.

A prospective study of 117 consecutive microsurgical reversals of female sterilization from April 1981 to December 1984 was carried out to determine which factors affected the pregnancy outcome. Nylon sutures, 8-0, were placed through the muscularis and mucosal layers. A short abdominal incision was made. The patients were followed for 3.5 to 7.0 years. The term delivery, intra-uterine pregnancy, spontaneous abortion and ectopic pregnancy rates were 81.2%, 83.8%, 1.7% and 1.7%, respectively; two ectopic pregnancies occurred 14 and 24 months after the reversal procedures. We found that the time interval between sterilization and reversal and the methods of sterilization affected the pregnancy outcome. The success rate with intervals of less than five years was much higher than with intervals of more than five years; Pomeroy cases were more reversible than Uchida cases. We did not observe any influence of the anastomosis site on the pregnancy results. The term delivery rates for isthmus-isthmus, isthmus-ampulla and ampulla-ampulla anastomoses were 78.8%, 80.0% and 84.6%, respectively. Patients should be followed for two years at least to determine the pregnancy outcome as well as the occurrence of ectopic pregnancy.