A Reconsideration of the Tubal Function-To Evaluate the Results Found Inside the Fallopian Tube When

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  Purpose: Although laparoscopy remains to be the gold standard for the evaluation of fallopian tubes, the process cannot be used to directly observe the inner cavity of the fallopian tube.Salpingoscopy, however, can be used to directly assess the mucosa of the infundibulium and ampulla.Therefore, we performed salpingoscopy concomitant to the performance of laparoscopy to glean more information about the fallopian tube.In this study, we tried to build an evaluation scoring system using the results of salpingoscopy, and to evaluate the relationship between this scoring system and the outcome of pregnancy.Materials and Methods: From April 2008 through October 2010, we recruited a total of 227 women for this study who had been diagnosed with unexplained infertility and who underwent both laparoscopy and salpingoscopy at our clinic.We observed the right and left tubal lumen paying particular attention to the following six findings: i) adhesions, ii) loss ofmucosal folds, iii) rounded edges of mucosal folds, iv) debris, v) foreign bodies, and vi) abnormal vessels by salpingoscopy.After salpingosopy, we calculated the F score which was our original score expressing the sum of the abnormal findings.One abnormal finding was given a 1-point of F score, the maximum was 12 points.We analyzed the relationship between the F scores and various clinical findings or pregnancy rates.Results: The average age of the patients was 33.8.About 51% of the patients showed an F score of 0, and the percentages of patients who showed 1, 2, 3 and 4, or more, points were 17.2, 13.2, 5.3, and 12.8%, respectively.After salpingoscopy, 71 patients achieved pregnancy within a year by timing intercourse or IUI.The pregnancy rates for patients with F scores of 0, 1 and 2 points were 35.9, 33.3, and 33.3% respectively, and the rate (34.9%) of patients with a low F score (F score-3d2) was significantly higher than that (14.6%) of patients with a high F score (F score ≥3d3, p<0.05).Conclusions: The patients showing a lower F score showed higher fecundity than those showing an F score of 3 or more without ART treatment.
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