Assessment of infertility surgery by a pelvic scoring system.
A pelvic scoring and staging system previously reported was used to evaluate 77 major microsurgical procedures during a 3-year period. Pregnancy rates by clinical assessment groups were (a) surgery indicated for tubo-ovarian adhesions (SGY:F) = 50%; (b) surgery indicated with other pelvic pathology, such as adnexal masses or myoma (SGY:F/etc) = 23%; and (c) surgery questionably indicated (SGY:?) = 18%. Using the scoring system, pregnancy rates by stage were 75%, 41%, and 14% for Stages I, II, and III, respectively. The pregnancy rate was higher in the pure tubal factor group as compared with those with additional infertility factors. Pelvic scores and stages correlated well with clinical expectations. Life-table analysis of cumulative pregnancy rates showed that all subsequent pregnancies occurred within the 24 months following surgery. A significant correlation noted between pelvic scores and cumulative pregnancy rates illustrates the system's usefulness in predicting reproductive potential postoperatively. This method can be used to assist the surgeon in establishing a couple's prognosis and to compare results between surgeons or different surgical techniques.
Wu
C H
CH
Department of Obstetrics and Gynecology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
Minassian
S S
SS
D000291:Adnexal Diseases / Q000150:complications / Q000473:pathology*; D005187:Fallopian Tubes / Q000601:surgery*; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000601:surgery*; D007813:Laparotomy; D008866:Microsurgery; D011247:Pregnancy; D012189:Retrospective Studies; D000267:Tissue Adhesions