OUTCOME STUDY USING AN ADMINISTRATIVE DATABASE - TERMINAL SALPINGOSTOMY, PHYSICIAN CASE LOAD AND LIVE BIRTH-RATES

Information on the outcome following salpingostomy performed for infer tility in everyday practice is needed to counsel patients, determine t he best approach to this condition and clarify whether the outcome is superior when surgery is performed by a physician who maintains a high volume of ongoing experience. A total of 547 consecutive subjects wer e identified over a 5 year period using the Alberta Health Care Claims Database, Their claims history was analysed over a follow-up of 2-7 y ears, to identify pregnancy-related events, loss to follow-up and even ts which would result in sterility, Pregnancies were crosschecked with the only in-vitro fertilization programme serving the region, The ove rall cumulative live birth and tubal pregnancy rates were 11.7 and 7.2 % respectively, Live birth rates were significantly higher when practi tioners had performed >10 procedures within the study period. Live bir th rates would appear to be substantially lower in everyday practice t han following surgery performed by acknowledged experts, A high volume of ongoing experience appears to be associated with superior live bir th rates, It is unclear whether this association relates to case selec tion, surgical expertise or both variables.