Recanalization of oviducts as well as spermatic ducts occur at a low promille rate after sterilization even if correctly performed. Therefore, pregnancies after unsuccessful sterilization cannot be taken as an immediate proof for a faulty surgical procedure. The surgeon is recommended to have the correctness of a sterilization confirmed in writing by competent witness of the operation (assistant doctor, nurse). Whenever possible, tissues of the occluded organs should be sent to the pathologist for histologic proof. In addition, special attention must be payed to a proper information of the patient on the failure rate in order to avoid the risk to become sued subsequently for incomplete information if the woman becomes pregnant. In the German jurisdiction, a child born after a faulty performed sterilization is classified as damage or cause of a damage according to the law of contract. Based on this judicial principle, a physicians may be sentenced to pay alimonies. This is felt by many physicians as an abasement of their professional engagement. It is also criticized, that suffering from an unwanted but otherwise normal pregnancy following faulty sterilization entitles a woman to financial compensations. Very recently, judicial differences in this respect have become known between the Federal Constitutional Court and the Federal Court. At present, it is still open which of the judicial points of view will finally predominate.
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Background: An estimated 17% of all couples worldwide are involuntarily childless (infertile). The clinically identifiable causes of infertility can be found in the male or female partner or in both. The molecular pathophysiology of infertility still remains unclear in many cases but is increasingly being revealed by genetic analyses.
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