Fertility following reversal of male and female sterilization.

It is estimated that 60% of Australian couples will opt for sterilization as a method of birth control. Approximately 0.5 to 1% of all sterilized males and females will request reversal. With tubal occlusion, it appears that the method used to produce occlusion, the occlusion site, the length of viable tube remaining and the time between sterilization and reversal appear to be predictive factors in producing intrauterine pregnancy. With the increasing tendency for sterilization to be performed in younger women, surgeons should consider performing surgery only on the isthmus of the tube, preserving as much undamaged tube as possible and using methods of occlusion other than diathermy to ensure adequate tubal occlusion and yet maintain optimum conditions should reversal be required. Successful pregnancy following vasovasostomy appears to be related primarily to length of time elapsed following vasectomy and to the skill of the surgeon in the use of microsurgical techniques, possibly aided by preservation of nerve supply to the vas. It is doubtful whether the presence of sperm antibodies in serum or semen will affect the return of fertility in most individuals, but further research is required to clarify this.