Microsurgical anastomosis of the fallopian tubes after tubal ligation: a systematic review and meta-analysis
Objective: Between 20% and 30% of women who have undergone tubal ligation regret their decision. The alternative to regain fertility for these women is either in vitro fertilization or tubal re-anastomosis. This article presents a systematic review with meta-analysis to assess the current evidence o...
| Autores: | , , , |
|---|---|
| Tipo de recurso: | artículo |
| Fecha de publicación: | 2023 |
| País: | España |
| Institución: | Universidad de Navarra |
| Repositorio: | Dadun. Depósito Académico Digital de la Universidad de Navarra |
| Idioma: | inglés |
| OAI Identifier: | oai:dadun.unav.edu:10171/68041 |
| Acceso en línea: | https://hdl.handle.net/10171/68041 |
| Access Level: | acceso abierto |
| Palabra clave: | Tubal reversal Tubal anastomosis Tubal reanastomosis Reproductive surgery IVF |
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Microsurgical anastomosis of the fallopian tubes after tubal ligation: a systematic review and meta-analysisSastre, J. (Juan)|||/items/4f60e4a7-486b-48bb-ace1-2d07ab159b91Mínguez-Milio, J.A. (José Ángel)|||/items/c10367d9-e049-41d1-b982-eb349d28614dAlcazar, J.L. (Juan Luis)|||/items/60547d4c-c930-4ef2-a41a-55ae849f2e96Chiva-de-Agustín, L. (Luis)|||/items/5aab5671-f48d-4295-8ae0-c8c88221e1f1Tubal reversalTubal anastomosisTubal reanastomosisReproductive surgeryIVFObjective: Between 20% and 30% of women who have undergone tubal ligation regret their decision. The alternative to regain fertility for these women is either in vitro fertilization or tubal re-anastomosis. This article presents a systematic review with meta-analysis to assess the current evidence on the efficacy of tubal recanalization surgery in patients who have previously undergone tubal ligation. Study design: The search was conducted in the World of Science (WOS) database, The Cochrane Library and ClinicalTrials.gov record using the keywords “tubal reversal”, “tubal reanastomosis” and “tubal anastomosis”. The review was carried out by two of the authors. Data from 22 studies were evaluated, comprising over 14,113 patients who underwent the studied surgery, following strict inclusion criteria: articles published between January 2012 and June 2022, in English and with a sample size bigger than 10 patients were included. A random-effects meta-analysis was performed. Results: The overall pregnancy rate after anastomosis was found to be 65.3 % (95 % CI: 61.0–69.6). The percentage of women who had at least one live birth, known as the birth rate, was 42.6 % (95 % CI: 34.9–51.4). Adverse outcomes after surgery were also examined: the observed abortion rate among women who underwent surgery was 9.4 % (95 % CI: 7.0–11.7), and the overall ectopic pregnancy rate was 6.8 % (95 % CI: 4.6–9.0). No differences were found between the outcomes when differentiating surgical approaches: laparotomy, laparoscopy, or robotic-assisted surgery. The patient’s age was identified as the most significant determining factor for fertility restoration. Finally, when comparing the results of tubal reversal with in vitro fertilization, reversal procedures appear more favorable for patients over 35 years old, while the results are similar for patients under 35 years old, but more data is needed to evaluate this finding. Conclusion: Therefore, the available literature review demonstrates that surgical anastomosis following tubal ligation is a reproducible technique with relevant success rates, performed by multiple expert groups worldwide.ElsevierDadun. Depósito Académico Digital Universidad de Navarra20232023-12-1220232023-01-0120232023-01-01journal articlehttp://purl.org/coar/resource_type/c_6501info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/10171/68041reponame:Dadun. Depósito Académico Digital de la Universidad de Navarrainstname:Universidad de NavarraInglésengopen accesshttp://purl.org/coar/access_right/c_abf2info:eu-repo/semantics/openAccessoai:dadun.unav.edu:10171/680412026-06-21T12:47:57Z |
| dc.title.none.fl_str_mv |
Microsurgical anastomosis of the fallopian tubes after tubal ligation: a systematic review and meta-analysis |
| title |
Microsurgical anastomosis of the fallopian tubes after tubal ligation: a systematic review and meta-analysis |
| spellingShingle |
Microsurgical anastomosis of the fallopian tubes after tubal ligation: a systematic review and meta-analysis Sastre, J. (Juan)|||/items/4f60e4a7-486b-48bb-ace1-2d07ab159b91 Tubal reversal Tubal anastomosis Tubal reanastomosis Reproductive surgery IVF |
| title_short |
Microsurgical anastomosis of the fallopian tubes after tubal ligation: a systematic review and meta-analysis |
| title_full |
Microsurgical anastomosis of the fallopian tubes after tubal ligation: a systematic review and meta-analysis |
| title_fullStr |
Microsurgical anastomosis of the fallopian tubes after tubal ligation: a systematic review and meta-analysis |
| title_full_unstemmed |
Microsurgical anastomosis of the fallopian tubes after tubal ligation: a systematic review and meta-analysis |
| title_sort |
Microsurgical anastomosis of the fallopian tubes after tubal ligation: a systematic review and meta-analysis |
| dc.creator.none.fl_str_mv |
Sastre, J. (Juan)|||/items/4f60e4a7-486b-48bb-ace1-2d07ab159b91 Mínguez-Milio, J.A. (José Ángel)|||/items/c10367d9-e049-41d1-b982-eb349d28614d Alcazar, J.L. (Juan Luis)|||/items/60547d4c-c930-4ef2-a41a-55ae849f2e96 Chiva-de-Agustín, L. (Luis)|||/items/5aab5671-f48d-4295-8ae0-c8c88221e1f1 |
| author |
Sastre, J. (Juan)|||/items/4f60e4a7-486b-48bb-ace1-2d07ab159b91 |
| author_facet |
Sastre, J. (Juan)|||/items/4f60e4a7-486b-48bb-ace1-2d07ab159b91 Mínguez-Milio, J.A. (José Ángel)|||/items/c10367d9-e049-41d1-b982-eb349d28614d Alcazar, J.L. (Juan Luis)|||/items/60547d4c-c930-4ef2-a41a-55ae849f2e96 Chiva-de-Agustín, L. (Luis)|||/items/5aab5671-f48d-4295-8ae0-c8c88221e1f1 |
| author_role |
author |
| author2 |
Mínguez-Milio, J.A. (José Ángel)|||/items/c10367d9-e049-41d1-b982-eb349d28614d Alcazar, J.L. (Juan Luis)|||/items/60547d4c-c930-4ef2-a41a-55ae849f2e96 Chiva-de-Agustín, L. (Luis)|||/items/5aab5671-f48d-4295-8ae0-c8c88221e1f1 |
| author2_role |
author author author |
| dc.contributor.none.fl_str_mv |
Dadun. Depósito Académico Digital Universidad de Navarra |
| dc.subject.none.fl_str_mv |
Tubal reversal Tubal anastomosis Tubal reanastomosis Reproductive surgery IVF |
| topic |
Tubal reversal Tubal anastomosis Tubal reanastomosis Reproductive surgery IVF |
| description |
Objective: Between 20% and 30% of women who have undergone tubal ligation regret their decision. The alternative to regain fertility for these women is either in vitro fertilization or tubal re-anastomosis. This article presents a systematic review with meta-analysis to assess the current evidence on the efficacy of tubal recanalization surgery in patients who have previously undergone tubal ligation. Study design: The search was conducted in the World of Science (WOS) database, The Cochrane Library and ClinicalTrials.gov record using the keywords “tubal reversal”, “tubal reanastomosis” and “tubal anastomosis”. The review was carried out by two of the authors. Data from 22 studies were evaluated, comprising over 14,113 patients who underwent the studied surgery, following strict inclusion criteria: articles published between January 2012 and June 2022, in English and with a sample size bigger than 10 patients were included. A random-effects meta-analysis was performed. Results: The overall pregnancy rate after anastomosis was found to be 65.3 % (95 % CI: 61.0–69.6). The percentage of women who had at least one live birth, known as the birth rate, was 42.6 % (95 % CI: 34.9–51.4). Adverse outcomes after surgery were also examined: the observed abortion rate among women who underwent surgery was 9.4 % (95 % CI: 7.0–11.7), and the overall ectopic pregnancy rate was 6.8 % (95 % CI: 4.6–9.0). No differences were found between the outcomes when differentiating surgical approaches: laparotomy, laparoscopy, or robotic-assisted surgery. The patient’s age was identified as the most significant determining factor for fertility restoration. Finally, when comparing the results of tubal reversal with in vitro fertilization, reversal procedures appear more favorable for patients over 35 years old, while the results are similar for patients under 35 years old, but more data is needed to evaluate this finding. Conclusion: Therefore, the available literature review demonstrates that surgical anastomosis following tubal ligation is a reproducible technique with relevant success rates, performed by multiple expert groups worldwide. |
| publishDate |
2023 |
| dc.date.none.fl_str_mv |
2023 2023-12-12 2023 2023-01-01 2023 2023-01-01 |
| dc.type.none.fl_str_mv |
journal article http://purl.org/coar/resource_type/c_6501 |
| dc.type.openaire.fl_str_mv |
info:eu-repo/semantics/article |
| format |
article |
| dc.identifier.none.fl_str_mv |
https://hdl.handle.net/10171/68041 |
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https://hdl.handle.net/10171/68041 |
| dc.language.none.fl_str_mv |
Inglés eng |
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Inglés |
| language |
eng |
| dc.rights.none.fl_str_mv |
open access http://purl.org/coar/access_right/c_abf2 |
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info:eu-repo/semantics/openAccess |
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open access http://purl.org/coar/access_right/c_abf2 |
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openAccess |
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application/pdf |
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Elsevier |
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Elsevier |
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reponame:Dadun. Depósito Académico Digital de la Universidad de Navarra instname:Universidad de Navarra |
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Universidad de Navarra |
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Dadun. Depósito Académico Digital de la Universidad de Navarra |
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