In:
Annals of the Academy of Medicine, Singapore, Academy of Medicine, Singapore, Vol. 49, No. 4 ( 2020-4-30), p. 180-185
Abstract:
Introduction:
We aim to compare live birth rates, cost analysis and a survey of patient attitudes between laparosopic tubal re-anastomosis and IVF.
Materials and Methods: Retrospective study: A retrospective study was done in a single reproductive medicine
and IVF unit in Singapore, from January 2011 to December 2016. Previously ligated patients underwent either laparoscopic tubal re-anastomosis or IVF. The primary
outcome was first live birth after treatment. Interval to first pregnancy, miscarriage and ectopic pregnancies were also reported. Survey: Patients attending the subfertility
clinic completed a questionnaire on IVF and tubal re-anastomosis, on preferred choice of treatment, before and after reading an information sheet.
Results: Retrospective study: 12 patients underwent tubal re-anastomosis while 31 patients underwent IVF treatment. Pregnancy (75.0% vs 35.5%) and live birth (58.3% vs 25.8%) were significantly higher in the tubal surgery group (P 〈 0.05%) after transferring all available embryos in one stimulated IVF cycle. Cost per live birth was lower in the tubal surgery group (SGD27,109 vs SGD52,438). Survey: One hundred patients participated in the survey. A majority of patients preferred tubal surgery to IVF (68.2% vs 31.8%) before given information on the procedures, but indicated a preference for IVF (54.6%) to surgery (45.4%) after receiving information on the procedures.
Conclusion: For women less than 40 years of age, desiring fertility after tubal ligation, laparoscopic tubal re-anastomosis offers better live birth rates and cost-effectiveness. Patients in Singapore are equivocal as to their preference after education regarding the choices. Thus laparoscopic tubal re-anastomosis remains a viable alternative to IVF treatment.
Key words: Artificial reproductive technology, Laparoscopic tubal reversal, Previous tubal ligation
Type of Medium:
Online Resource
ISSN:
0304-4602
DOI:
10.47102/annals-acadmedsg.
DOI:
10.47102/Annals-acadmedsg.2019214
Language:
English
Publisher:
Academy of Medicine, Singapore
Publication Date:
2020
detail.hit.zdb_id:
2186627-2
