[Microsurgical therapy in tubal sterility]

In spite of the advances in the field of in vitro-fertilization, microsurgery still offers the best chances for treatment of tubal infertility. Because of the irreversible tubal wall pathology the results following microsurgical repair of the postinfectious tubal disease are limited to approximately 30%. No further improvement of the surgical technique is to be expected. According to the birth rate and the rate of extrauterine gestation, microsurgery gives the best results in the correction of filmy adhesions, fimbrial phimosis and proximal tubal occlusion. Distal tubal occlusion with development of hydrosalpinx and extremely thickness of the wall should be treated by IVF-ET. If higher rates of pregnancy are to be achieved in the future in tubal sterility, the treatment of methods (microsurgery, endoscopy and extracorporeal fertilization) must be combined.