The role of fallopian tube anastomosis in training fellows: A survey of current reproductive endocrinology fellows and practitioners

Armstrong, Alicia; Neithardt, Adrienne B.; Alvero, Ruben; Sharara, Fady I.; Bush, M.; Segars, James H.

doi:10.1016/j.fertnstert.2004.02.107

Cited by 12 publications

(10 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, IVF is not without complications and has a risk of ectopic pregnancy and multiple pregnancies. In this respect, the importance of training for tubal reanastomosis has been recently re-emphasized (Armstrong et al, 2004). As a friendlier and more advantageous method of restoring fertility than IVF in patients wanting pregnancy after having their tubes ligated, the tubal reanastomosis method should also yield a high pregnancy rate.…”

Section: Introductionmentioning

confidence: 99%

High pregnancy rate after microsurgical tubal reanastomosis by temporary loose parallel 4-quadrant sutures technique: a long long-term follow-up report on 961 cases

Moon¹,

Joo²,

Park³

et al. 2012

Human Reproduction

View full text Add to dashboard Cite

background: Only a limited portion of sterilized women undergo tubal reanastomosis due to high costs, limited availability of qualified practitioners willing to perform the procedure and increasing success rates with IVF. However, IVF has complications and an increased risk of ectopic pregnancy and multiple pregnancies. Recently, the importance of specialized training for tubal anastomosis has been re-emphasized. This study aimed to report the procedure of our microsurgical tubal reanastomosis by a temporary loose parallel 4-quadrant suture technique and its high pregnancy outcome over the last 20 years.methods: This clinical study retrospectively analyzed data on 961 consecutive patients who underwent tubal reversal between March 1988 and August 2007 in a large urban medical center. All surgical operations were performed by microsurgical tubal reanastomosis using a temporary loose parallel 4-quadrant suture technique by a single surgeon. Subsequent pregnancy outcomes were evaluated. results:The overall pregnancy rate was 85.1, 82.6 being intrauterine and 2.5% ectopic. The pregnancy rate was significantly reduced in patients over 40 years old (53.9%) compared with patients aged 40 years or less (90.3%) (P , 0.05). Repair done at the interstitial -ampulla site yielded a significantly higher ectopic pregnancy rate (20.0%) compared with other anastomosis sites (0-3.2%) (P , 0.001). conclusions:This study shows that our technique resulted in a high pregnancy rate comparable with the level of natural fertility. The study also reveals that ectopic pregnancy frequently occurs in tubal reanastomosis of the interstitial -ampulla site compared with other sites.

show abstract

Section: Introductionmentioning

confidence: 99%

High pregnancy rate after microsurgical tubal reanastomosis by temporary loose parallel 4-quadrant sutures technique: a long long-term follow-up report on 961 cases

Moon¹,

Joo²,

Park³

et al. 2012

Human Reproduction

View full text Add to dashboard Cite

show abstract

“…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. According to one US survey, 43% of fellows had not performed a TA as primary surgeon (5). Among the reasons for this trend is the increasing success rate of IVF.…”

mentioning

confidence: 99%

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

View full text Add to dashboard Cite

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.

show abstract

“…The lack of access to tubal anastomosis is unfortunate not only for our patients today but for future generations of patients as reproductive surgery is no longer an integral part of many fellowship training programs. A survey of reproductive endocrinology fellows reported that 43% of them had not performed a tubal anastomosis as the primary surgeon, a number that has almost certainly increased substantially in the 15 years since this publication (21). It is concerning that tubal anastomosis may no longer be a treatment option for restoring fertility after tubal sterilization.…”

Section: Tubal Surgerymentioning

confidence: 99%

Current controversies in tubal disease, endometriosis, and pelvic adhesion

Goldberg

Falcone

Diamond³

2019

Fertility and Sterility

View full text Add to dashboard Cite

Reproductive surgery for proximal and distal tubal occlusion, as well as for reversal of tubal ligation, may be an alternative or an adjunct to IVF. Surgery for adenomyosis and endometriosis, including endometriomas, may be considered for the treatment of infertility and/or pelvic pain but carries the risks of surgical complications and diminished ovarian reserve. A greater understanding of the pathogenesis of postoperative peritoneal adhesion formation is needed to develop more effective preventive measures to optimize the clinical results of surgery. (Fertil Steril Ò 2019;112:417-25. Ó2019 by American Society for Reproductive Medicine.

show abstract

The role of fallopian tube anastomosis in training fellows: A survey of current reproductive endocrinology fellows and practitioners

Cited by 12 publications

References 6 publications

High pregnancy rate after microsurgical tubal reanastomosis by temporary loose parallel 4-quadrant sutures technique: a long long-term follow-up report on 961 cases

High pregnancy rate after microsurgical tubal reanastomosis by temporary loose parallel 4-quadrant sutures technique: a long long-term follow-up report on 961 cases

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

Current controversies in tubal disease, endometriosis, and pelvic adhesion

Contact Info

Product

Resources

About