Live birth following day surgery reversal of female sterilisation in women older than 40 years: a realistic option in Australia?

Objective: To determine the live birth rate following surgical reversal of sterilisation in women aged 40 years and older.

Design: Retrospective cohort study of pregnancy outcome following day surgery microsurgical reversal of sterilisation performed by two reproductive microsurgeons in the private sector.

Setting And Patients: 47 patients (aged 40 years or older) who had reversal of sterilisation performed between 1997 and 2005 in Adelaide, South Australia (n=35), or the Infertility Centre of St Louis, Missouri, USA (n=12).

Infertility caused by HCG autoantibody.

An anti-hCG autoantibody was found in a patient with a 9-yr history of secondary infertility. Although the patient had regular menstrual cycles, had conceived spontaneously, and had good hormonal and follicular responses to gonadotropic stimulation regimens during the in vitro fertilization work-up, she presented with apparent recurrent pregnancy loss associated with prolonged raised hCG levels. Initially the presence of a high mol wt hCG complex was demonstrated in the serum by gel chromatography.