Technical results of falloposcopy for infertility diagnosis in a large multicentre study

Despite increasing evidence of its potential clinical value, falloposcopy h as not yet found widespread use. In a large prospective international multi centre study we investigated the hypothesis that limited technical reproduc ibility may be of crucial significance in this regard. From 1994 to 1998, d ata on 367 patients with 639 tubes were recorded from 18 centres (median nu mber of falloposcopies 22). Falloposcopy was performed using hysteroscopic ostium access, coaxial tubal cannulation and retrograde visualization under laparoscopic control. The procedure was successful in 69.6% of the tubes. Failures occurred in 6.1% during hysteroscopy, in 10.6% during the cannulat ion step and in 16.4% during visualization. While predominantly intracavita ry pathology or thick endometrium were found to interfere with hysteroscopi c ostium access, technical insufficiencies resulting in catheter damage or vision disturbing light reflexions were identified to be responsible for mo st cannulation and visualization failures, confirming the importance of the se factors. The number of patients who received a complete falloposcopic ev aluation did not exceed 57%, Additionally, 23.7% of patients may have profi ted from unilateral success depending on the individual indication. As a co nsequence of these technically limited results it was concluded that the me thod currently qualifies for selected indications rather than for routine c linical application.