Live delivery outcome after tubal sterilization reversal A population based study

Capsule:
Within the first 5 years after sterilization reversal, at least 50% of women sterilized before the age of 40 years successfully deliver a child, but the delivery rate halves after the age of 40 years.

Authors:
Eva Malacova, Ph.D., Anna Kemp-Casey, Ph.D., Alexandra Bremner, Ph.D., Roger Hart, M.D., C.R.E.I., Louise Maree Stewart, Ph.D., David Brian Preen, Ph.D.

Volume 104, Issue 4, Pages 921-926

Abstract:

Objective:
To determine the cumulative incidence of live delivery in women who underwent reversal of tubal sterilization.

Design:
Population-based retrospective cohort study.

Setting:
Hospitals in Western Australia.

Patient(s):
All women aged 20–44 years, with a history of hospital admission for tubal sterilization, who subsequently underwent reversal of sterilization during the period 1985 to 2009 in Western Australia (n = 1,898).

Intervention(s):
Data regarding reversal of sterilization and prior tubal sterilization were extracted from routinely collected administrative hospital separation records, until commencement of IVF treatment.

Main Outcome Measure(s):
First live-delivery rates.

Result(s):
There were 969 first live deliveries observed during the study period. The overall cumulative live-delivery rate was 20% (95% confidence interval [CI] 18–23) within the first year after reversal, 40% (95% CI 38–42) at 2 years, 51% (95% CI 48–53) at 5 years, and 52% (95% CI 50–55) at 10 years. The 5-year cumulative live-delivery rate was significantly lower in women who were aged 40–44 years (26%) compared with younger women (aged 20–29, 30–34, and 35–39 years) (50%, 56%, and 51%, respectively).

Conclusion(s):
Women undergoing reversal of sterilization before they reach age 40 years have at least a 50% chance of delivering a live baby within the next 5 years. Up to that age, there is no significant difference in live deliveries. The live-delivery rate halves after the age of 40 years.

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