Our Summary

The research paper investigates whether a surgical procedure called bilateral tubotubal anastomosis is successful for women who want to have children after they’ve had their tubes tied (a form of sterilization). The study finds that this procedure is indeed an effective treatment for outpatient women.

The study involved tracking more than 6,000 women who had this surgery between January 2000 and June 2013. The researchers found that 69% of these women became pregnant after the procedure, with 35% of them giving birth. The chances of becoming pregnant and giving birth were highest for women under 30 who had their sterilization reversed. The chances decreased as the woman’s age increased.

The method of sterilization also influenced the success rate. Women who had their sterilization reversed by coagulation (a process that uses heat to destroy tissue) had the lowest success rates. Women who had their sterilization reversed by ligation/resection (a process that involves tying or cutting the tubes) had moderate success rates.

The study has some limitations, including the potential for underreporting or misreporting of pregnancies and overreporting of ectopic pregnancies (a condition where the fetus grows outside the womb). The researchers also acknowledge that the associations they found between age, method of sterilization, and subsequent pregnancy need to be validated with additional research.

Despite these limitations, the study’s findings can help patients and doctors understand that bilateral tubotubal anastomosis may be a viable alternative to in-vitro fertilization (IVF).

FAQs

  1. What is bilateral tubotubal anastomosis and who is it recommended for?
  2. How does the method of sterilization impact the success rate of bilateral tubotubal anastomosis?
  3. What are the limitations of the study on bilateral tubotubal anastomosis?

Doctor’s Tip

One helpful tip a doctor might tell a patient considering bilateral tubal ligation is to discuss the potential risks and benefits of the procedure, as well as alternative options for future fertility. It’s important for patients to have a thorough understanding of the procedure and its potential outcomes before making a decision. Additionally, patients should be aware that success rates may vary based on factors such as age and method of sterilization, so it’s important to discuss these factors with your healthcare provider.

Suitable For

Patients who are typically recommended bilateral tubal ligation are women who have previously undergone tubal ligation as a form of permanent contraception but now desire to have children. The study suggests that women under 30 who had their sterilization reversed are more likely to have successful outcomes, though success rates decrease with age. Additionally, the method of sterilization used in the initial procedure can also impact the success rate of the reversal surgery. Women who had their sterilization reversed by ligation/resection had moderate success rates compared to those who had coagulation.

Timeline

Before bilateral tubal ligation:

  1. Patient consults with their healthcare provider about permanent birth control options.
  2. Patient decides to undergo bilateral tubal ligation, a surgical procedure to block or remove the fallopian tubes to prevent pregnancy.
  3. Patient undergoes pre-operative evaluations and counseling to ensure they understand the procedure and its implications.
  4. Patient undergoes the surgical procedure, typically done under general anesthesia.
  5. Patient may experience some pain, discomfort, and recovery time after the surgery.

After bilateral tubal ligation:

  1. Patient may experience some side effects such as abdominal pain, bloating, or vaginal bleeding immediately after the surgery.
  2. Patient is advised to take it easy and avoid strenuous activities for a period of time to allow for proper healing.
  3. Patient follows up with their healthcare provider for post-operative care and monitoring.
  4. Patient may experience changes in their menstrual cycle or hormonal balance due to the procedure.
  5. If the patient later decides they want to have children, they may consider options such as in-vitro fertilization or bilateral tubotubal anastomosis to reverse the sterilization.

What to Ask Your Doctor

  1. What is bilateral tubal ligation and how does it work?
  2. What are the reasons for considering a reversal of bilateral tubal ligation?
  3. What are the success rates of pregnancy and live birth after bilateral tubotubal anastomosis?
  4. What factors can affect the success rates of the procedure?
  5. What are the potential risks and complications associated with the procedure?
  6. How long is the recovery time after the surgery?
  7. What is the likelihood of experiencing an ectopic pregnancy after the procedure?
  8. Are there any age limitations for undergoing a reversal of bilateral tubal ligation?
  9. What alternative options are available for women who are not successful with this procedure?
  10. How many procedures of this nature have you performed and what is your success rate?

Reference

Authors: Berger GS, Thorp JM Jr, Weaver MA. Journal: Hum Reprod. 2016 May;31(5):1120-5. doi: 10.1093/humrep/dew038. Epub 2016 Mar 14. PMID: 26980770