SALPINGOSCOPY IS AN IMPORTANT PART OF THE INFERTILITY WORK-UP

Study Objectives. To assess the efficacy of salpingoscopy as a routine part oi the infertility work-up by comparing laparoscopic findings wi th salpingoscopic findings, and to match the pregnancies achieved by t he patients with findings obtained from the endoscopic evaluation. Des ign. A retrospective study conducted between January 1990 and June 30, 1994. Patients. One hundred twenty-four women undergoing infertility investigations. Two were suspected of having pelvic inflammatory disea se, and one had an extrauterine pregnancy. Setting. The Jan Palfijn Ge neral Hospital, Antwerp, Belgium. Interventions. Video hysteroscopy, l aparoscopy, and salpingoscopy were performed in every patient. Adhesio lysis was done in 46 and neosalpingostomy in 5. Salpingoscopy was perf ormed on 188 fallopian tubes; 60 tubes (24.15%) could not be cannulate d. Drilling of polycystic ovaries was done in eight patients, ovarian cystectomy in five, and myomectomy in one. Endometriosis lesions were treated in 38 women. Measurements and Main Results. In 3 of 13 women w ho were diagnosed as having endometritis at hysteroscopy, salpingoscop y revealed severe lesions of the mucosal folds. Of the normal-looking tubes at laparoscopy, 25.8% had mucosal lesions. Of the abnormal looki ng tubes at laparoscopy, only 13.5% had normal mucosal folds. More tha n one-fourth (28.5%) of patients with endometriosis AFS I and II had m ucosal lesions. The number of pregnancies achieved by these women corr elated well with salpingoscopy except in those with class III lesions. Conclusion. This study confirms that tubes that look normal externall y can have lesions of the endosalpinx. A maximum possibility of sponta neous pregnancy exists when the mucosal folds are normal. Class III le sions are compatible with fertility although the probability is reduce d. With severe mucosal lesions the chances of spontaneous pregnancy ar e very remote.