Failed outpatient sterilization procedures not associated with adverse pregnancy outcomes

While the risk of pregnancy is low after female sterilization procedures, 60 percent of pregnancies that do occur result in a live birth, according to a new study. Researchers looked at data from close to 1,000 pregnancies after failed outpatient and surgical sterilization procedures and found that while neither option was associated with adverse pregnancy outcomes, outpatient procedures were more likely to result in a live birth and less likely to result in an ectopic pregnancy, which occurs outside of the uterus, when compared to surgical options.

The risk of becoming pregnant after sterilization is rare, occurring in less than one percent of all women who have a procedure. There is little research comparing the pregnancy outcomes of laparoscopic, requiring surgery, and hysteroscopic sterilization, which generally takes place in an outpatient setting. During laparoscopic sterilization, surgeons clamp, block, or sever and seal a woman's fallopian tubes to prevent pregnancy. During hysteroscopic procedures, a tiny device is inserted into each fallopian tube. Scar tissue will form around the device to block the tubes and prevent pregnancy.

Each procedure carries its own risks; this study did not explore or comment on risks outside of pregnancy outcomes after sterilization failure.

Researchers looked at pregnancy outcomes using the MarketScan Database, which includes health data from about half of U.S. women with private insurance. They found women who had outpatient hysteroscopic sterilization were 32 percent more likely have a live birth than those who had laparoscopic surgery. Those women were also 88 percent less likely to have an ectopic pregnancy. Both groups experienced similar risk of having a miscarriage or preterm birth, and stillbirths were rare.

There were relatively small differences overall between women with hysteroscopic and laparoscopic sterilizations, with most pregnancies resulting in a live birth. Researchers say this is data that can help physicians counsel patients who are considering sterilization procedures.

The study was published online in Obstetrics & Gynecology.