Tubal Anastomosis Surgery in A Public Hospital Operating as A Secondary Care Facility: One-Year Experience

Objective: To describe the characteristics, management and treatment options of patients with a history of tubal sterilization who wish to become pregnant again and prefer tubal anastomosis (TA) surgery for this purpose, examine the factors involved in deciding on treatment options, describe our surgical technique and review our results.Methods: Between January 2020 and January 2021, all women who underwent TA surgery with the mini-laparotomy approach in a high-density public hospital were retrospectively examined.After describing the surgical technique, demographic data, medical characteristics, peri-and postoperative features including pregnancy rates and outcomes of participants were retrospectively reviewed.Results: After excluding five patients with missing data, two patients who underwent concomitant myomectomy and endometriosis surgery and one patient who refused to participate, 13 participants were included in the study.Eleven of these women became pregnant after TA surgery, while the overall pregnancy and live birth rates were 84.6% and 53.8%, respectively.No woman older than 40 years had a live birth. Conclusion:Parallel to the rise in divorce rates and subsequent new marriages in our country, we are increasingly facing with women who have undergone tubal sterilization and wish to become pregnant again.In vitro fertilization (IVF) should be considered as an option for this group of patients, especially for those over 40 years of age, as TA surgery carries some surgical and anesthesiologic risks.However, even in times of significant advances in assisted reproductive techniques, TA still plays an important role with satisfactory results in restoring fertility after tubal ligation.Tubal anastomosis via a mini-laparotomy with pure saline pertubation is a safe, inexpensive and effective option for such patients, especially for couples with limited financial resources or for couples who are planning more than one pregnancy and do not wish to undergo IVF for religious reasons.