The relationship of abnormalities of the Fallopian tubes in patients with tubal infertility due to hydrosalpinges and fertility outcome after salpingoneostomy was studied in a prospective multicentric project. Hydrosalpinges of infertile patients were evaluated macroscopically and microscopically at the time of salpingoneostomy and the results were analysed with regard to the fertility outcome. Peritubal adhesions, the diameter and the quality of the mucosa were scored at the time of surgery and biopsies from representative areas were evaluated by scanning electron and light microscopy in 50 patients with bilateral hydrosalpinges or a hydrosalpinx of a single tube. Analysis of the different factors for fertility outcome was performed using the Cox proportional hazards model. No intrauterine pregnancy occurred in the thick-walled hydrosalpinges group (n = 13). In the thin-walled hydrosalpinx group (n = 37), 15 intrauterine and two tubal pregnancies occurred. The aspect of the mucosa as evaluated by an operating microscope was the most important factor in determining the fertility outcome; > 50% abnormal mucosa was associated with an intrauterine pregnancy rate of 7% which increased significantly to 50 and 69% when the mucosa was > 50 and 75% normal respectively. The pregnancy rate was not influenced by the presence or extent of peritubal adhesions but small sized (< 1 cm) hydrosalpinx had a better prognosis than medium (1-2 cm) and large sized (> 2 cm) hydrosalpinx. When mucosal adhesions were present (n = 19), the intrauterine pregnancy rate was 22% which increased significantly to 58% when adhesions were absent (n = 18). Both tubal pregnancies occurred in tubes with mucosal adhesions.(ABSTRACT TRUNCATED AT 250 WORDS)

A technique of translaparoscopic salpingoscopy is utilized to evaluate the ampullary segment of the Fallopian tube in patients suffering from infertility. Comparison of this technique with hysterosalpingography in a series of 32 patients with hydrosalpinges demonstrates its superiority in the evaluation of the tubal mucosa. This new diagnostic approach allows a more accurate selection of patients for either microsurgical repair, in-vitro fertilization (IVF) or gamete intra-Fallopian transfer (GIFT).

Summary. Fallopian tubes containing a gestation are frequently normal on macroscopical and gross histological examination. Scanning electron microscopy and light microscopy studies of tubal biopsies taken from five groups of women showed marked differences in the ciliated surface which was measured planimetrically on photographs. The proportion of ciliated cells was significantly lower in biopsies taken from 25 women with tubal pregnancies compared with that in biopsies from seven women with intrauterine pregnancies at the same gestation. Marked deciliation was also seen in eight women biopsied during tubal surgery sometime subsequent to an ectopic pregnancy and in four women biopsied during tubal surgery who subsequently had a tubal pregnancy when compared with a group of women biopsied during tubal sterilization.

No abstract

No abstract