Tubal recanalisation: study of factors for successful outcome

Objectives: To study the pregnancy rate following tubal recanalisation and to analyse the factors that influence the outcome. Materials and Methods: The study carried out in Jawaharlal Institute of Postgraduate Medical Education and Research, between July 2006 and August 2007 includes two group. All the patients undergoing recanalisation were included as the prospective group (40) and in the retrospective group (20) case records of those women who had undergone tubal recanalisation in the previous year were included. A detailed history was elicited; a thorough clinical examination was done followed by routine laboratory evaluation. After obtaining the informed written consent, recanalisation was done, as per the protocol and the parameters were noted. Then, they were followed-up for one year. Results: Out of 60 patients, 5 patients were lost to follow up and in the remaining 55 patients, the pregnancy rate was 58.2%; all were intrauterine pregnancies - 23 delivered, 5 aborted and 4 were ongoing pregnancies. There was no case of ectopic pregnancy. The conception rate was high when the age of the patient was < 30 years (84.3%), interval between sterilisation and its reversal was <4 years (73.3%), following laparoscopic sterilisation (66.6%), site of anastomosis being isthmo-isthmic (78.5%) and the remaining tubal length was >6 cm (67.6%). Conclusion: The factors associated with successful tubal recanalisation are i) age of the patient <30 years ii) interval between sterilisation and its reversal <4 years iii) site of anastomosis isthmo-isthmic and iv) remaining tubal length >6 cm. Also, improved results were obtained following laparoscopic sterilisation.