The role of severe adnexal disease in tubal reconstructive surgery.

Fifty two consecutive women underwent microsurgical reconstruction of the tubes. Thirty one percent conceived and 19% delivered live infants. Medical history suggestive of pelvic infection was obtained in 44% of the women. Fifty four percent had extensive, coarse and fibrous adhesions. Tubal reconstruction in these patients did not yield any pregnancies. Severity of the adnexal disease should be evaluated before attempted tubal reconstructive surgery. Women with severe adnexal damage should be referred to in vitro fertilization.