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Salpingoscopy: An Adjuvant to Laparoscopy in Evaluation of Infertile Women
Vineet V Mishra1, Rajani Nawal1, Rohina S Aggarwal1
1Department of Obstetrics and Gynaecology, the Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Ahmedabad, India.
Objective:
To evaluate salpingoscopic tubal mucosal grading and to find out correlation between laparoscopic external tubal appearance and salpingoscopic mucosal appearance.
Design:
Prospective observational study.
Intervention:
Salpingoscopy and laparoscopy.
Materials And Methods:
Thirty-seven infertile women between 21 and 40 years of age group who attended infertility clinic at IKDRC, Ahmedabad, from May 2015 to August 2015, were enrolled in the study. Laparoscopic tubal morphology was classified as regular, convoluted and hydrosalpinx. Salpingoscopic findings were graded (Grade I-Grade V) according to Brosens classification.
Results:
Laparoscopic appearance of tube was regular in 18 (48 %), convoluted in 17 (45.94 %), and hydrosalpinx in 2 (5.4 %) women. Salpingoscopic findings were graded as Grade I in 14 (37.83 %), Grade II in 10 (27.02 %), Grade III in 8 (21.62 %), Grade IV in 3 (8.10 %), and Grade V in 2 (5.4 %) women. Discordance between laparoscopic and salpingoscopic findings, i.e. regular appearance on laparoscopy and Grade III-Grade V appearance on salpingoscopy, was found in 38.88 % women.
Conclusion:
Laparoscopy alone might not be sufficient to predict tubal integrity and salpingoscopic endotubal grading may help in infertility treatment selection decisions. Early counselling towards IVF-ET can be encouraged in cases with higher grade.
