Can fallopian tube anatomy predict pregnancy and pregnancy outcomes after tubal reversal surgery?

Abstract

We conducted this study to determine if postoperative fallopian tube anatomy can predict the likelihood of pregnancy and pregnancy outcomes after tubal sterilisation reversal. We built a flexible, non-parametric, multivariate model via generalised additive models to assess the effects of these tubal parameters observed during tubal reparative surgery: tubal lengths; differences in tubal segment location and diameters at the anastomosis sites; and, fibrosis of the tubal muscularis. Age and tubal length (in that order) are the primary features determining the likelihood of pregnancy. For pregnancy outcomes, age is the primary predictor of miscarriage, but tubal length is the most influential predictor of the odds of birth and ectopic pregnancy. Segment location and diameters contribute slightly to the odds of miscarriage and ectopic pregnancy, whereas fibrosis has little apparent effect. This study is the first to show that a statistical learning predictive model based on fallopian tube anatomy can predict both pregnancy and pregnancy outcome probabilities after tubal reversal surgery.