Proximal tubal occlusion: is there an alternative to microsurgery?

Human Reproduction
J B DubuissonM C Vacher-Lavenu

Abstract

Fertility outcome following microsurgical tubocornual anastomosis by laparotomy was evaluated. A total of 131 women presenting pure proximal occlusion, whether bilateral or in one tube only, were treated between January 1978 and December 1993. Subsequent fertility was studied in 120 patients, 11 being patients lost to follow-up. Cumulative intrauterine pregnancy (IUP) rate, evaluated by life-table analysis, was 68% at 24 months. The overall IUP rate, calculated from a group of 120 women with follow-up > or = 2 years, and including births and miscarriages, was 70% after 2 years. Comparisons of the cumulative IUP rates show that the fertility outcome is significantly better if the woman is aged < or = 36 years and if tubocornual anastomosis is carried out bilaterally. These results from our personal series confirm that microsurgical tubocornual anastomosis is still of prime importance in the treatment of pure proximal occlusions. Nevertheless, considerable progress in the fields of tubal catheterization, Falloposcopy and in-vitro fertilization techniques raises the question of the management of patients presenting with a proximal tubal occlusion. Here we define the indications for microsurgical tubocornual anastomosis.

Citations

Sep 29, 2011·Archives of Gynecology and Obstetrics·Cordula SchippertGuillermo-José Garcia-Rocha
Jan 11, 2000·Clinical Obstetrics and Gynecology·K SpielvogelC C Coddington
Feb 22, 2012·Human Fertility : Journal of the British Fertility Society·Maria KotrotsouGeoffrey Trew
Jul 19, 2003·Human Fertility : Journal of the British Fertility Society·Fong LokTin C Li
Nov 4, 2004·BJOG : an International Journal of Obstetrics and Gynaecology·Gavin Sacks, Geoff Trew
Jun 19, 2010·Orvosi hetilap·István SzabóZoltán Langmár

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