title: A new classification system for pregnancy prognosis of tubal factor infertility.
abstract: The aim of the present study was to assess the objectivity and accuracy of a new system to evaluate pregnancy prognosis in tubal factor infertility (TFI) patients. Retrospective study in 469 TFI patients were pre- and postoperatively scored using the new system as mild, moderate or severe TFI, based on tubal adhesions, patency, morphology and structure. Follow-up was assessed to determine pregnancy outcomes. Laparoscopic salpingoplasty and hydrotubation, hysteroscopic-laparoscopic salpingoplasty and hydrotubation, and laparoscopic hydrotubation all decreased TFI scores to a similar extent. The pre- and postoperative TFI classification was significantly associated with intrauterine pregnancy (mild: 43.6% vs. moderate: 34.0% vs. severe: 19.4%, P < 0.0001) and live births (mild: 35.9% and moderate: 31.5% vs. severe: 16.8%, P = 0.0002) rates. Multivariate analysis showed that the preoperative disease course (P = 0.02), preoperative TFI score (P < 0.0001), and postoperative TFI score (P = 0.0007) were independently associated with the rate of intrauterine pregnancy rate. Multivariate analysis also showed that the postoperative TFI score (P = 0.001), pelvic inflammatory disease (P = 0.03) and age (P = 0.03) were independently associated with the rate of live births.
  
  
  CONCLUSIONS
  We devised a new classification system for TFI prognosis. Salpingoplasty improved these scores. Both pre- and postoperative TFI assessments using this new system are associated with pregnancy prognosis in TFI patients.
authors.affiliation: Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University Shanghai 200090, China.
authors.forename: Shi-En
authors.initials: SE
authors.lastname: Zou
authors.affiliation: Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University Shanghai 200090, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Jin
authors.affiliation: Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University Shanghai 200090, China.
authors.forename: Yi-Ling
authors.initials: YL
authors.lastname: Ko
authors.affiliation: Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University Shanghai 200090, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Zhu
keywords: Tubal factor infertility; follow-up; retrospective analysis; salpingoplasty; tubal classification system