THE ASSESSMENT OF TUBAL FUNCTIONAL STATUS BY TUBAL PERFUSION-PRESSUREMEASUREMENTS

The measurement of tubal perfusion pressures (TPP) is a recent advance in the field of gynaecoradiology. Measurement of TPP involves a stand ardized technique using transcervically placed tubal catheters which i s reviewed in detail. TPP assess es the functional status of the Fallo pian tubes, i.e. their ability to permit pregnancy. Infertile patients with normal TPP demonstrated a higher pregnancy rate (10 out of 23) t han patients with elevated TPP (four out of 24, P <0.05). Analysis of patients who had undergone a laparoscopy as well as measurement of TPP suggest that elevated TPP are highly indicative of tubal endometriosi s. Tubal catheterization with wireguides was successful in reducing mi ldly elevated TPP. The impact of this procedure on pregnancy rates is not known. The use of the gynaecoradiological techniques discussed in this paper has reduced the need for diagnostic laparoscopy at our cent re by >60%. This was achieved without compromise in pregnancy rates an d has resulted in a considerable reduction in cost.