title: First and subsequent pregnancies after tubal microsurgery: evaluation of the fertility index.
abstract: OBJECTIVE
  To determine the number of children born after a tubal microsurgical operation and to evaluate the fertility index, a long-term measure of reproductive potential.
  
  
  METHODS
  A case series involving a follow-up questionnaire.
  
  
  METHODS
  A tertiary care university hospital.
  
  
  METHODS
  Three hundred twelve women undergoing microsurgery for tubal disease.
  
  
  METHODS
  A range of open microsurgical procedures including reversal of sterilizations.
  
  
  METHODS
  Cumulative pregnancy rates to the first and second normal pregnancies and calculation of the fertility index.
  
  
  RESULTS
  The 2-year cumulative pregnancy rates (probability +/- SE) for a first normal pregnancy for proximal disease, distal disease, tubal reanastomoses, and tubal adhesions were 0.51 +/- 0.05, 0.29 +/- 0.06, 0.47 +/- 0.06, and 0.30 +/- 0.07, respectively. Of the 288 (92%) women responding to the questionnaire, 142 women had at least one child. Of the 100 women who wanted a second child, 68 succeeded, the proportions being similar in each surgery category. The fertility index described restoration of normal fertility in 30%, 12%, 34%, and 23% for women with proximal disease, distal disease, anastomotic procedures, and adhesion disease, respectively.
  
  
  CONCLUSIONS
  The fertility index is a useful measure of long-term reproductive potential. The high recurrent pregnancy rate emphasizes the value of microsurgery in restoring normal fertility to some women.
authors.affiliation: Department of Obstetrics and Gynaecology, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. wayne.gillett@stonebow.otago.ac.nz
authors.forename: W R
authors.initials: WR
authors.lastname: Gillett
authors.forename: R H
authors.initials: RH
authors.lastname: Clarke
authors.forename: G P
authors.initials: GP
authors.lastname: Herbison
mesh_terms: D000328:Adult; D005184:Fallopian Tube Diseases / Q000601:surgery*; D005260:Female; D005298:Fertility; D005500:Follow-Up Studies; D006801:Humans; D008866:Microsurgery; D011247:Pregnancy; D011379:Prognosis; D011795:Surveys and Questionnaires; D013997:Time Factors