Clinical implications of accessory fallopian tube ostium in endometriosis and primary infertility

Several variations in fallopian tube anatomy may be noted during the evaluation of infertility. Some anatomical variants such as accessory tubal ostia are rare. A 31-year-old woman presented to our center with a 2-year history of primary infertility. Given her history of dysmenorrhea, a diagnostic laparoscopy was performed. Laparoscopy revealed a left utero-sacral endometriosis implant, which was resected. Although the left fallopian tube was normal, the right fallopian tube was noted to have two prongs with individual ostia. Tubal cannulation confirmed two separate ostia, with chromotubation showing free flow of dye through separate fimbrial ostia of the right fallopian tube. The current case highlights that accessory tubal ostia are rare müllerian duct anomalies seen during laparoscopy and can be associated with endometriois or primary infertility.