Government-funding program on reversal of tubal sterilization.
Bai BC, Park CM, Kwak HM, Whang YW.
Korean Association for Voluntary Sterilization, Seoul.
Abstract
Three hundred and sixty-one women were provided government-funded sterilization reversal services with the technique of microsurgery. A large majority of reasons (89.8%) for requesting reversal surgery was a loss of children, and the mean interval between sterilization and reversal was 28.7 months. Two hundred and seven (69.7%) of 297 follow-up cases have experienced term delivery or intra-uterine pregnancy and 5 cases were ectopic pregnancy. The largest number of reversal clients (63.3%) were sterilized by the laparoscopic unipolar coagulation technique and the next largest group (24.2%) was sterilized by the laparoscopic banding technique. The highest pregnancy rate (77.8%) was shown in clients who had undergone laparoscopic banding technique while the lowest (65.9%) was the group of laparoscopic unipolar coagulation. A more than 60% of the clients became pregnant within 6 months of their reversal surgery, with the shortest interval being 1 month, the longest 39 months, and the mean 7.6 months. A large majority of the successful cases, 81.6%, were pregnant within 1 year of their reversal surgery.
PIP: Physicians at 15 institutions in the Republic of Korea conducted microsurgery to reverse tubal sterilization in 361 22-38 year old women (mean 28.8 years) of parity 0-2 (mean 0.4) between 1980 and 1988. The government paid for the sterilization reversal services. The leading reason for regret and reversal of tubal sterilization was death of a child (89.8%). The researchers were able to follow up on 297 cases (18 months-8 years after reversal surgery). 69.7% (207) of the cases became pregnant after tubal sterilization. Most reversal clients (63.3%) had had laparoscopic unipolar coagulation followed by the laparoscopic banding technique (24.2%). The laparoscopic banding technique resulted in a more successful reversal rate (77.8%), however. Only 65.9% of clients who had had laparoscopic unipolar coagulation became pregnant. The most successful reversal by sterilization type was for clients who had had postpartum Pomeroy technique (90%). The most successful reversal by anastomosis site was isthmic-isthmic (80.9%) and the least successful was cornual-ampullary (64.9%). 61.8% became pregnant within 6 months after reversal and 81.6% within 1 year. The success rate was highest among the women who underwent their reversal 25-36 months after the sterilization (78.4%) and the lowest rate among those with an interval of 37-48 months (53.5%). The mean interval between reversal and conception was 7.6 months, the shortest interval being 1 month and the longest 39 months. As voluntary sterilization occurs more often at lower parity among younger women, Korea expects to continue to see more sterilization reversal requests.
Source: U.S. National Library of Medicine, National Institutes of Health – http://www.ncbi.nlm.nih.gov/pubmed/1627062