Reconstructive, organ-preserving microsurgery in tubal infertility: still an alternative to in vitro fertilization
Received 31 January 2009; received in revised form 6 August 2009; accepted 7 August 2009. published online 28 September 2009.
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.
aDepartment of Obstetrics and Gynecology, Division of Reproductive Medicine, Hannover Medical School, Hannover, Germany
bCenter for Obstetrics and Paediatrics, University Hospital of Hamburg Eppendorf (UKE), Hamburg, Germany
Reprint requests: Cordula Schippert, M.D., Department of Obstetrics and Gynecology, Division of Reproductive Medicine, OE 6410, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany (FAX: +49-511-532-6094).
C.S. has nothing to disclose. C.B. has nothing to disclose. P.S. has nothing to disclose. U.H. has nothing to disclose. B.H. has nothing to disclose. G-J.G-R. has nothing to disclose.
ABSTRACT