Live delivery outcome after tubal sterilization reversal: a population-based study

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.

Keywords: Cohort studies; life tables; live birth; sterilization reversal; tubal sterilization.