E.T. Young

Salpingoscopy: systematic use in diagnostic laparoscopy.

OBJECTIVE To evaluate the importance of salpingoscopy together with laparoscopy in the diagnosis of tubal pathology. DESIGN Salpingoscopy was performed as a complementary method in patients who were subjected to diagnostic laparoscopy. The relationship between the salpingoscopy and (1) the patients previous history of tubal disease and (2) laparoscopic diagnoses was evaluated. SETTING Private patients referred to the Instituto de Fertilidad, Buenos Aires. PATIENTS, PARTICIPANTS Forty-two patients undergoing a diagnostic laparoscopy during the evaluation of their fertility or as a follow-up of previous therapy. MAIN OUTCOME MEASURE(S) Salpingoscopy was performed, using a colpomicrohysteroscope. We evaluated alterations in major and minor folds and their vascularization, the presence of microadhesions, and cellular nuclei dyed with methylene blue in the tubal lumen. RESULTS Fifty percent of the patients who had no previous history of tubal disease presented with endosalpingeal alterations, and in 37% of the normal laparoscopies the salpinx had unilateral or bilateral salpingoscopic abnormalities. CONCLUSIONS Salpingoscopy is a useful method to evaluate oviducts, before assuming their normality, and consideration of these women for assisted reproductive technology.

In vitro fertilization and embryo transfer program at the Instituto de Fertilidad, Buenos Aires, Argentina.

No. of patients 84 No. of cycles 158 Cancellation (cycle) 50 Ovum pickups Laparoscopies 56 Ultrasound 52 No. of retrieved oocytes 602 No. of oocytes/patient 7.2 Fertilization rate 64% No. of cleaved oocytes 273 Embryo/transfer 2.9 No. of clinical pregnancies 15 Abortions 3 Ectopic pregnancy 1 Intrauterine + ectopic 1 Ongoing (over 20 weeks) 7 Deliveries 4 No. of live babies 5 Pregnancy/pickup 13.8% Pregnancy/tran sfer 15.9% Pregnancy/patie nt 17.8%