Prospective evaluation of falloposcopy.
The aim of this study was to evaluate the feasibility of routine falloposcopy in infertile patients undergoing basic infertility investigations, and to determine its usefulness in comparison with other tubal investigation methods. Seventy-five infertile women were selected based on the following criteria: 2 years of infertility, age between 18 and 40 years, normal ovulation, and partner with normal spermatozoa. Based on the results of the classical means of tubal evaluation (hysterosalpingography and laparoscopy), these patients were classified in one of two groups: tubal or unexplained infertility. All patients underwent a falloposcopy under general anaesthesia. The procedures were performed by the same surgeon with the linear everting catheter. Based on the falloposcopic findings, these patients were then reclassified in one of two other groups: falloposcopic tubal or falloposcopic unexplained infertility. The mean outcome measures were catheterization rate, duration of the procedure, pregnancy rates, complication rate and predictive value of Falloposcopy. The tubal catheterization rate was 94.5%. The mean duration of falloposcopy was 19 min per tube. Based on a standard scoring system, the spontaneous pregnancy rates were 27.6% for a score <20; 11.5% for a score between 21 and 30; and 0% if the score was >30. Complication rate was 5.1% of pinpoint perforations of the tube. With Cox's statistical model, none of the parameters analysed was statistically predictive of intrauterine pregnancy. We conclude that the greater accuracy of diagnosis by falloposcopy may indicate that it should be incorporated into the initial screening of infertile patients.
Dechaud
H
H
Service de Gynécologie-Obstétrique, CHU Arnaud de Villeneuve, Montpellier, France.
Daures
J P
JP
Hedon
B
B
D000293:Adolescent; D000328:Adult; D003944:Diagnostic Techniques, Obstetrical and Gynecological; D004724:Endoscopy; D005184:Fallopian Tube Diseases / Q000150:complications / Q000175:diagnosis*; D005187:Fallopian Tubes / Q000473:pathology*; D005260:Female; D006801:Humans; D007047:Hysterosalpingography; D007247:Infertility, Female / Q000145:classification / Q000209:etiology*; D010535:Laparoscopy; D011247:Pregnancy; D011446:Prospective Studies