[Distal tubal obstructions: microsurgery or in vitro fertilization]

Laser CO2 microsurgical salpingostomies were performed among 70 infertile patients from 1979 to 1982. 9 patients lost to follow up were excluded. All patients underwent a preoperative hysterosalpingography and a laparoscopy in order to realise a tubal evaluation. 4 groups of tubal damage were defined with a subsequent pregnancy rate of: 66.66% in group I, 37.5% in group II, 5.55% in group III, 0% in group IV. 4 groups of adhesions were defined with a subsequent pregnancy rate of: 42.85% in group 0, 33.33% in group mild, 25% in group moderate, 5.85% in group severe. From this results the authors propose a tubal and adhesions score in order to select patients for microsurgery or in vitro fertilization.