Tubal anastomosis following unipolar cautery

Twenty-five of 48 women (52%) sterilized by unipolar cautery techniques conceived following tubal anastomosis, of whom 17 (36%) had a living child. The overall cumulative probability of conception at the end of follow-up as determined by life-table analysis was 76%. Increasing age, parity, and the duration of the interval from sterilization to reversal did not influence pregnancy success. A decreased pregnancy rate was associated with ampullary-isthmic anastomosis; however, a pregnancy was least likely to occur in women with shortened oviducts of ≤4 cm (P<0.01). A decreased pregnancy rate in cautery-sterilized patients undergoing reversal may be related to the destruction of a larger segment of the fallopian tube. Interestingly, 71% of the cautery-sterilized patients were noted to have associated tubal disease such as endometriosis and/or proximal hydrosalpinx. The influence of these findings on subsequent pregnancy success remains to be established.