The results of tubal surgery in the treatment of infertility in Wellington 1986-90.

AIMS

To audit the outcome of tubal surgery performed in Wellington between 1986-90. To establish the appropriate indications for tubal surgery in terms of likely benefit. To compare benefit with other treatment modalities namely in vitro fertilisation.

METHODS

Data obtained from hospital patient notes, theatre records and personal communication.

RESULTS

There were 71 patients, 67 of whom had been adequately followed up. The total pregnancy rate was 41.8% with an overall term pregnancy rate of 29.8%. The success rate was highest with proximal tubal occlusion and worst for distal disease and endometriosis.

CONCLUSION

The outcome of the audit is consistent with results worldwide. Tubal surgery allows for natural conception and more than one pregnancy can be conceived as a result. It should be considered the first line treatment for proximal tubal disease and fimbrial adhesions. In vitro fertilisation however should be offered to those with severe distal disease and severe endometriosis.