Committee opinion: role of tubal surgery in the era of assisted reproductive technology

doi:10.1016/j.fertnstert.2011.12.031

Cited by 64 publications

(13 citation statements)

References 68 publications

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“…In this model, IVF remained more cost effective for women more than 40 years of age (data not shown). This is consistent with the ASRM practice bulletin that notes age as the most important prognostic factor for TA (4). …”

Section: Discussionsupporting

confidence: 89%

“…More than 30% of couples in the United States elect to undergo surgical sterilization (1). There are more than 650,000 tubal ligations performed each year in the United States and up to 30% will come to regret the decision with 1% ultimately seeking reversal (2–4). The most common reasons cited for seeking anastomosis after tubal ligation are a change in marital status and desire for more children (2, 3).…”

mentioning

confidence: 99%

“…An American Society for Reproductive Medicine Committee Opinion supports TA as an option for post-tubal ligation fertility and, when considering options, reports age as the most important prognostic factor (4). However, in spite of the reported success rates, TA is being performed less frequently, and taught less frequently in fellowship training programs in the United States.…”

mentioning

confidence: 99%

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Cost and efficacy comparison of in vitro fertilization and tubal anastomosis for women after tubal ligation

Messinger

Alford

Csokmay

et al. 2015

Fertility and Sterility

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Objective To compare cost and efficacy of tubal anastomosis to in vitro fertilization (IVF) in women who desired fertility after a tubal ligation. Design Cost-effectiveness analysis. Setting Not applicable. Patient(s) Not applicable. Intervention(s) Not applicable. Main Outcome Measure(s) Cost per ongoing pregnancy. Result(s) Cost per ongoing pregnancy for women after tubal anastomosis ranged from $16,446 to $223,482 (2014 USD), whereas IVF ranged from $32,902 to $111,679 (2014 USD). Across maternal age groups <35 and 35–40, years tubal anastomosis was more cost effective than IVF for ongoing pregnancy. Sensitivity analyses validated these findings across a wide range of ongoing pregnancy probabilities as well as costs per procedure. Conclusion(s) Tubal anastomosis was the most cost-effective approach for most women less than 41 years of age, whereas IVF was the most cost-effective approach for women aged ≥41 years who desired fertility after tubal ligation. A model was created that can be modified based on cost and success rates in individual clinics for improved patient counseling.

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Section: Discussionsupporting

confidence: 89%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Cost and efficacy comparison of in vitro fertilization and tubal anastomosis for women after tubal ligation

Messinger

Alford

Csokmay

et al. 2015

Fertility and Sterility

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“…Tubal pathology accounts for 25-35 % of female factor infertility, with more than half of the cases due to pelvic inflammatory disease (PID) [43]. A history of ectopic pregnancy, pelvic PID, endometriosis, or prior pelvic surgery can be considered as risk factors for tubal factor fertility [44].…”

Section: Tubal Patencymentioning

confidence: 99%

Female Fertility Assessment

Choussein

Vlahos

2012

Curr Obstet Gynecol Rep

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A fastidious fertility evaluation designed to discern all factors contributing to a couple's inability to conceive is the quintessential approach to a well-justified, costeffective treatment plan. The purpose of this review is to outline the steps of female infertility evaluation as well as all evidence-based methods in a reproductive endocrinologist's armamentarium to perform it. Evaluation should always start with the least invasive approaches for detection of the most common causes of infertility. The most common identifiable causes of female infertility include ovulatory disorders, tubal blockade or other reproductive tract pathology (irregular cervical mucus production, endometriosis, pelvic adhesions), and/or other medical condition interacting with the above (hyperprolactinemia, thyroid disorder). Incessant advancement of Assisted Reproductive Technology techniques renders more and more infertility causes amenable to treatment; a rational use of available approaches in terms of both personalized feasibility and cost-effectiveness should be applied.Keywords Female infertility . Assisted reproductive technology . Evaluation of ovulatory function . Evaluation of female reproductive tract . Tubal patency . Hysterosalpingo-contrast sonography (HyCoSy) . Evaluation of ovarian reserve . Serum anti-müllerian hormone (AMH)

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“…Tubal disease accounts for 25–35% of female-factor infertility (American Society of Reproductive Medicine, 2012, Honore et al , 1999). Tubal disease is most common in the form of a hydrosalpinx, which is an accumulation of serous fluid in the Fallopian tube that usually results from pelvic infection by gonorrhoea, chlamydia or both (Yoder and Hall, 1991) and ultimately leads to tubal occlusion.…”

Section: Introductionmentioning

confidence: 99%

State-mandated insurance coverage is associated with the approach to hydrosalpinges before IVF

Omurtag¹,

Grindler²,

Roehl³

et al. 2014

Reproductive BioMedicine Online

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The aim of this study was to determine whether practice in states with infertility insurance mandates is associated with physician-reported practice patterns regarding hydrosalpinx management in assisted reproduction clinics. A cross-sectional, internet-based survey of 442 members of Society for Reproductive Endocrinology and Infertility or Society of Reproductive Surgeons was performed. Physicians practising in states without infertility insurance mandates were more likely to report performing diagnostic surgery after an inconclusive hysterosalpingogram than physicians practising in states with mandates (RR 1.2, 95% CI 1.1–1.3, P < 0.01). Additionally, respondents in states without mandates were more likely to report that, due to lack of infertility insurance coverage, they did not perform salpingectomy (SPX) or proximal tubal occlusion (PTO) before assisted reproduction treatment (RR 1.4, 95% CI 1.1–1.8, P = 0.01). Finally, respondents in states without mandates were less likely to report that the presence of assisted reproduction treatment coverage determined the urgency with which they pursued SPX or PTO before treatment (RR 0.7, 95% CI 0.5–1.0, NS). These results persisted after controlling for physician years in practice, age and clinic volume. In conclusion, self-reported physician practice interventions for hydrosalpinges before assisted reproduction treatment may be associated with state-mandated infertility insurance.

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Committee opinion: role of tubal surgery in the era of assisted reproductive technology

Cited by 64 publications

References 68 publications

Cost and efficacy comparison of in vitro fertilization and tubal anastomosis for women after tubal ligation

Cost and efficacy comparison of in vitro fertilization and tubal anastomosis for women after tubal ligation

Female Fertility Assessment

State-mandated insurance coverage is associated with the approach to hydrosalpinges before IVF

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