Weight loss ups pregnancy odds after tubal reversal

OB/GYN News,  Feb 1, 2003  by Heidi Splete

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MIAMI BEACH -- A woman's odds of pregnancy after a tubal reversal get worse with increasing BMI.

However, whether another procedure is done at the same time as sterilization is not a factor in whether a woman later becomes pregnant, Dr. Magdi Hanafi said at the annual meeting of the American Association of Gynecologic Laparoscopists.

In a retrospective clinical study, 63 patients were followed for at least 12 months after tubal reversal. Patients averaged 25 years old at the time of tubal ligation and had undergone the procedure a mean of almost 9 years earlier. At the time of sterilization approximately 43% of patients had a concurrent hysteroscopy, and 33% had a concurrent myomectomy, said Dr. Hanafi, a gynecologic surgeon in Atlanta.

After tubal reversal, the overall cumulative pregnancy rate was 56% at 12 months' follow-up, 68% at 24 months, and 73% at 36 months.

Pregnant women were significantly younger than nonpregnant women at follow-up (mean 32.3 years vs. 36.6 years), and the duration of sterilization was significantly shorter in pregnant women (8 years vs. 11 years).

Most patients became pregnant within 18 months after tubal reversal, Dr. Hanafi said.

Although body mass index was not a statistically significant factor, women with a BMI of less than 25 became pregnant significantly more quickly after their surgeries, compared with women with a BMI greater than 25. This association may give an overweight woman incentive to lose weight, Dr. Hanafi said. "We can tell her that if she loses weight it will increase her chances of getting pregnant" after the surgery.

Pregnancy rates in women who had concurrent myomectomy or hysteroscopy were lower than in those who didn't have concurrent procedures, but the differences were not significant.

Hysterosalpingogram results were used to assess the condition of the fallopian tubes after surgery but were not a reliable predictor of pregnancy rates.

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