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Salpingoscopic and laparoscopic investigations in relation to fertility outcome
G L Marchino1, V Gigante, G Gennarelli
1Department of Gynecological and Obstetrical Sciences, S. Anna Hospital, University of Turin, Via Baiardi 43, Turin 10126, Italy.
Study Objective:
To evaluate the correlation between salpingoscopic and laparoscopic findings and their relation to reproductive outcomes.
Design:
Prospective study (Canadian Task Force classification II-2).
Setting:
University-affiliated hospital.
Patients:
Ninety-one infertile women.
Intervention:
Salpingoscopy and laparoscopy.
Measurements And Main Results:
Salpingoscopic findings were expressed according to a widely used classification. Tubal morphology at laparoscopy was defined as regular (normal morphology), convoluted (any kind of distortion or adhesion), or hydrosalpinx. Laparoscopic and salpingoscopic findings did not correlate. Seventeen pregnancies occurred within 1 year from the procedures. According to life table analysis, the cumulative pregnancy rate was significantly higher in women with endotubal morphology showing minimal or no tubal damage, than in women with higher grades of endotubal damage. Conversely, tubal morphology at laparoscopy was not able to predict pregnancy outcome.
Conclusion:
Laparoscopy alone might not be sufficient to predict tubal integrity. Performing salpingoscopy with laparoscopy could significantly increase accuracy in predicting short-term fertility outcome. Given its low complication rate and brief duration, salpingoscopy should have a primary role in management of infertility.