Laparoscopic reconstructive tubal surgery in a tertiary referral centre - a review of 177 cases
Objectives. To establish the pregnancy rate (PR) following endoscopic reconstructive tubal surgery in patients with tubal disease presenting to the Reproductive Medicine Unit at Groote Schuur Hospital between January 1994 and December 1997.
Design. A prospective descriptive study utilising the Hulka classification system of tubal disease scored at the time of surgery and correlating the findings and procedures carried out with the pregnancy outcome.
Setting and subjects. Patients with infertility referred from level 1 and 2 health care facilities in the Western Cape to the Reproductive Medicine Unit in the Department of Obstetrics and Gynaecology at Groote Schuur Hospital.
Outcome measures. The main outcome measure was the PR following reconstructive surgery. Secondary outcome measures included the number of patients undergoing assisted reproductive techniques (ART) and the outcome of in vitro fertilisation and embryo transfer (IVFlET).
Results. The results of 177 patients were analysed. The spontaneous PR for these patients was 13.6% per patient, with a live birth rate of 9%. The spontaneous extra-uterine pregnancy rate was 3.4% per patient and accounted for 25% of all spontaneous conceptions. Twenty-five patients (14% of the study population) underwent IVFlET resulting in a PR of 36% per patient and 33.3% per-embryo transfer.
Conclusions. The poor PR following endoscopic tubal reconstruction is predominantly attributed to the severity of tubal damage in the study population. Patients undergoing IVFlET had a favourable PR - indicating that most of these couples are highly fertile but for the mechanical obstruction. The results of our study support ART as first-line therapy in the majority of patients with tubal factor infertility in the setting of this study.
Copyright remains in the Author’s name. The work is licensed under a Creative Commons Attribution - Noncommercial Works License. Authors are required to complete and sign an Author Agreement form that outlines Author and Publisher rights and terms of publication. The Agreement form should be uploaded along with other submissions files and any submission will be considered incomplete without it [forthcoming].
Material submitted for publication in the SAMJ is accepted provided it has not been published or submitted for publication elsewhere. Please inform the editorial team if the main findings of your paper have been presented at a conference and published in abstract form, to avoid copyright infringement. The SAMJ does not hold itself responsible for statements made by the authors.
Previously published images
If an image/figure has been previously published, permission to reproduce or alter it must be obtained by the authors from the original publisher and the figure legend must give full credit to the original source. This credit should be accompanied by a letter indicating that permission to reproduce the image has been granted to the author/s. This letter should be uploaded as a supplementary file during submission.