Predictors of success of reversal of sterilization

Abstract

Objective: To determine the prognostic variables effecting the successful pregnancy outcome of reversal of sterilization.

Design: Demographic and clinical history data were collected prospectively.

Setting: Division of Infertility and Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada.

Patients and intervention: Between 1981 and 1992, 217 consecutively referred patients underwent reversal of sterilization by a single surgeon using microsurgical techniques.

Main outcome measures: Prognostic variables associated with success were examined using logistic regression and expressed as odds ratios with corresponding 95% confidence intervals.

Results: Age at reversal was a significant factor with the odds of a successful outcome for those < or = 35 years compared with those > 35 years being 2.3 with a 95% confidence interval of 1.3 to 4.1. There was some evidence that average tubal length as categorized in 2-cm intervals was a significant prognostic factor with the odds of a successful outcome for those with an average length of > 4 cm to those < or = 4 cm being 5.3 with a 95% confidence interval of 1.4 to 20.0.

Conclusions: Nonsubjective analysis of the prognostic variables of reversal of sterilization associates only age and tubal length of > 4 cm with intrauterine pregnancy.

PIP: This study was designed to determine which prognostic variables influence the successful pregnancy outcome of reversal of sterilization. The study is prospective, pertains to a single surgeon with the exclusive use of the microscope, uses nonsubjective grouping of prognostic factor categories, and examines the power of the study to detect clinically meaningful associations. Over the period 1981-92, 217 consecutively referred patients underwent reversal of sterilization by a single surgeon using microsurgical techniques. Logistic regression found age at reversal to be a significant factor, with the odds of a successful outcome for those aged 35 and younger compared with those older than 35 being 2.3 with a 95% confidence interval of 1.3-4.1. There was some evidence that average tubal length as categorized in 2-cm intervals was a significant prognostic factor, with the odds of a successful outcome for those with an average length of more than 4 cm to those less than or equal to 4 cm being 5.3 with a 95% confidence interval of 1.4-20.0. Nonsubjective analysis of the prognostic variables of the reversal of sterilization therefore associates only age and tubal length of more than 4 cm with intrauterine pregnancy.