Reconstructive, organ-preserving microsurgery in tubal infertility: still an alternative to in vitro fertilization.
In this retrospective study, we observed a total of 553 patients with tubal infertility who underwent microsurgical reconstructive surgery of the fallopian tubes (including adhesiolysis, anastomosis, fimbrioplasty, salpingostomy, and refertilization after former sterilization). The pregnancy (43.4%) and birth (29.2%) rates after microsurgery for acquired tubal damages (abortion: 6.4%; ectopic pregnancy: 7.9%) were higher than after single in vitro fertilization (28.4% and <20%, respectively; data from German IVF register). The pregnancy (73%) and birth (50.6%) rates after the reversal of sterilization also were higher (abortion: 15.7%; ectopic pregnancy: 6.7%). The advantages of reconstructive microsurgery over in vitro fertilization include the ideally permanent restoration of a woman's ability to conceive naturally in every cycle that she ovulates, a high postoperative birth rate overall, and avoidance of multiple births.
Schippert
Cordula
C
Department of Obstetrics and Gynecology, Division of Reproductive Medicine, OE 6410, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. schippert.cordula@mh-hannover.de
Bassler
Christina
C
Soergel
Philipp
P
Hille
Ursula
U
Hollwitz
Bettina
B
Garcia-Rocha
Guillermo-Jose
GJ
D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female; D011247:Pregnancy; D019651:Plastic Surgery Procedures / Q000379:methods