Assessment of fallopian tube cytology for the diagnosis of endometriosis and hydrosalpinx.

Fallopian tube cytology has been used as a useful tool in the diagnosis of infertility. In this study, we developed an intra-fallopian tube cell collection method with the simultaneous use of a laparoscope and hysteroscope, and examined its safety and applicability for the diagnoses of endometriosis and hydrosalpinx. Fallopian tube cells were collected at laparoscopy and hysteroscopy from 20 volunteer patients who visited the infertility clinic. There were 10 patients with normal fallopian tubes (Group 1), 7 with pelvic endometriosis (Group 2), and 3 with hydrosalpinx (Group 3). The collected cells were fixed onto glass slides using an auto-smear method, stained by the Papanicolaou method and subjected to detailed cytomorphological examinations. In each case, an adequate number of cells with well-preserved morphology for a reliable evaluation was obtained. Cells from normal fallopian tubes were mainly fallopian tube epithelial cells including ciliated columnar cells and secretory cells. The number of inflammatory cells was quite low. A characteristic feature in cases with pelvic endometriosis was the presence of a large number of macrophages, some of which showed hemosiderin phagocytosis. In contrast, cases with hydrosalpinx showed an extremely low cellular component. No complications were found in any of the patients. Our study indicates that the present intra-fallopian tube cell collection method using a laparoscope and hysteroscope is a reliable and safe method that can be applied to the diagnosis of endometriosis, hydrosalpinx, as well as pelvic infertility.