Tubal Reversal Pregnancy Study Report 2007

Pregnancy Outcomes After Tubal Reversal At Chapel Hill Tubal Reversal Center

Notice of Study Update

The following is Dr. Berger's report from 2007. The corresponding page of an updated report can be seen at Tubal Reversal Pregnancy Study 2009 - Pregnancy Outcomes

Pregnancy Outcomes By Age

Table 8 shows the relationship between age and pregnancy outcome. With increasing age, the percentage of pregnancies resulting in births declined due to an increasing percentage of miscarriages. Among women under age 35, over half of pregnancies resulted in birth or ongoing pregnancy while one third miscarried. The birth rate declined and the miscarriage rate increased significantly for women ages 40 and older. The ectopic pregnancy rate was higher than that found in the general population of women who have not had a tubal ligation, which is approximately 2.5%. The ectopic pregnancy rate after tubal reversal surgery, however, may be overstated since many early pregnancy losses were reported as ectopic pregnancies without confirmation of the diagnosis. Some of these pregnancies may have been miscarriages. Whether there is an increased risk of miscarriage associated with tubal reversal is unclear. The miscarriage rate reported in the general population ranges from approximately 20% to 50% depending on a woman's age and the extent of early pregnancy testing.

**Table 8. Pregnancy Outcomes by Age**
Age	Pregnant	Birth/Ongoing	Miscarriage	Ectopic
<30	460	255 (55%)	149 (32%)	56 (12%)
30-34	1130	567 (50%)	371 (33%)	192 (17%)
35-39	978	451 (46%)	373 (38%)	154 (16%)
40+	207	83 (40%)	94 (45%)	30 (15%)
Total	2775	1356 (49%)	978 (36%)	432 (16%)

Pregnancy Outcomes By Tubal Ligation Method

Table 9 shows the relationship between the tubal ligation method and pregnancy outcome. Tubal ligation reversal after clips or rings resulted in a significantly higher birth rate (60%) and a lower ectopic pregnancy rate (9%) than other tubal ligation methods.

**Table 9. Pregnancy Outcomes by Tubal Ligation Method**
Method	Pregnant	Birth/Ongoing	Miscarriage	Ectopic
Clip/ring	697	418 (60%)	217 (31%)	62 (9%)
Ligation/resection	1098	507 (46%)	407 (37%)	184 (17%)
Coagulation	805	354 (44%)	298 (37%)	153 (19%)
Unknown	175	77 (44%)	65 (37%)	33 (19%)
Total	2775	1356 (49%)	987 (36%)	432 (16%)

Pregnancy Outcomes By Fallopian Tube Length

Longer tubes were associated with better pregnancy outcomes than shorter tubes (Table 10). Among women with average fallopian tube lengths measuring 7.5 cm or longer, 59% gave birth or had an ongoing pregnancy. Birth rates declined while miscarriage and ectopic pregnancy rates increased with shorter tubal lengths.

**Table 10. Pregnancy Outcomes by Tubal Length (cm)**
Length	Pregnant	Birth/Ongoing	Miscarriage	Ectopic
7.5+	295	180 (61%)	86 (29%)	29 (10%)
5.0-7.4	1624	846 (52%)	554 (34%)	224 (14%)
2.5-4.9	801	312 (39%)	324 (40%)	165 (21%)
<2.5	38	12 (32%)	17 (45%)	9 (24%)
Total	2758	1350 (49%)	981 (36%)	427 (16%)