Robotic Laparoscopic Tubal Reversal

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One of Dr. Hanafi’s surgical specialties is Tubal Reversal procedures. Below is a synopsis of one of his published studies:


Dr. Hanafi published a medical study paper, “Factors Affecting the Reproductive Outcome after Microsurgical Tubal Reversal”. It was published in the August 2003 issue of Fertility and Sterility journal. This study was made up of 128 patients that had tubal reversal performed by Dr. Hanafi between October 1992 and May 2001.


The average age of these patients was 33, but they ranged in age from 22 to 46. Several months after surgery, 88% of the patients had at least one verifiably open tube, and 86% of these had a subsequent pregnancy. The overall pregnancy rate in the patients followed after surgery was 75%.


Factors affecting Pregnancy Rate (PR)
There was no statistically significant difference in PR between the methods of tubal sterilization (tied, burned or clamped).


Age was a significant factor, and it had the strongest association with the pregnancy rate when compared with the other factors. The PR decreased considerably as patient age increased; it was 96% in patients 30 years old or younger, 80% in patients 31-35 years, and 45% in patients older than 35 years.


The advancement of age is linked to a reduction in the ovarian reserve function, in the quality of the ova, and in the sexual function. There is also an inreased risk of diseases with age advancement; among these are gynecological conditions such as fibroid tumors and menstrual irregularities, which can have some bearing on the PR after tubal reversal surgery.


If you are considering tubal reversal surgery, it is important to try to have the procedure sooner rather than later. This will help maximize your chances for pregnancy by minimizing the age effect that has been demonstrated by this study and others. However, 25% of the patients 42-44 years of age did conceive after tubal reversal.


Body Mass Index (BMI) was also a significant factor on the PR, with the PR diminishing gradually as BMI increased. The PR was 85% for BMI of 25 or less (normal), 73% for BMI 26-29 (overweight), and 59% for BMI 30 or over (obese).


Being overweight is associated with hormonal changes and with low sexual function because of negative body image. If your BMI is over 25, you should try to reduce your weight to improve your chances for pregnancy. The weight factor can be modified, although not easily, by dieting and exercise before and after reversal surgery.


Duration of sterilization was a significant factor; the PR by number of years after tubal ligation was 91% for 1-5 years, 81% for 6-10 years, 72% for 11-15 years, and 22% for 16-20 years. There was a moderate correlation between age and number of years sterilized, which likely had some effect on these results. However, even after controlling for age, there was a higher PR in those sterilized 5 years or less.


Age was the dominant significant factor affecting pregnancy rate in tubal reversal patients. Body mass index and duration of sterilization had smaller, but statistically significant, associations with PR.


If you are interested in getting a complete manuscript of this study, please contact the office and we will provide you with one.