SUBTLE TUBAL ABNORMALITIES ADVERSELY AFFECT GAMETE INTRAFALLOPIAN TRANSFER OUTCOME IN WOMEN WITH ENDOMETRIOSIS

Objectives: To evaluate prospectively the impact of subtle tubal disor ders on GIFT pregnancy rates in women with pelvic endometriosis. Desig n: A prospective comparison of pregnancy rates in different stages of endometriosis while controlling for the presence of tubal abnormalitie s. Interventions: A total of 146 patients with endometriosis underwent 201 GIFT procedures. During laparoscopy special attention was brought to the fallopian tubes and any anatomical disorders were recorded. Tu bal abnormalities included tubal sacculations, diverticulae, convoluti ons, phimosis, fimbrial agglutination, and peritubal adhesions. Best t ube was considered in the final analysis. Results: The presence of tub al abnormalities significantly lowered the pregnancy rates in all stag es of endometriosis. When we controlled for age, semen characteristics , number of mature oocytes transferred, and tubal status, the extent o f anatomical tubal disorders was the most important prognostic factor in determining pregnancy outcome. Conclusion: The extent of tubal abno rmalities rather than the stage of endometriosis seems to be an import ant prognostic factor in determining GIFT pregnancy rates. Couples sho uld be counseled accordingly and accurate prognostic parameters should be explained before enrollment in a GIFT program.