JLE

Médecine de la Reproduction

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Reappraisal of distal tubal infertility in 2016 Volume 18, issue 4, Octobre-Novembre-Décembre 2016

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Authors
1 Institut Robert B. Greenblatt, 35, rue Turenne, 33000 Bordeaux, France
2 Service d’obstétrique, gynécologie et reproduction, centre hospitalier universitaire de Clermont-Ferrand, France
* Tirés à part

Distal tubal occlusions remain a frequent cause of infertility. The estimated prevalence of tubal infertility in developed countries is 25 %. The main causes of tubal obstruction are either infectious (STD) or iatrogenic (Post-surgical). Chlamydia trachomatis (CT) is the most frequent agent involved in many countries. Screening of CT is an efficient preventive measure. Diagnosis of tubal occlusions is based upon past history evaluation, CT serology, hysterography and echosonography. Pelvic endoscopy still remains the gold standard. The method of microsurgical management was reinitiated in the mid-seventies and rapidly became the recommended procedure and all basic principles of tubal surgery for infertility were then established. Then the laparoscpic approach was offered as a valuable alternative with quite similar results and lesss invasiveness. Several series of laparoscopic treatment of tubal occlusions have been publihed. But the number of cases is sometimes limited, selection of cases undergoing surgery and method of results evaluation are variable. We thus decided to report a continuous series of 434 cases of tuboplasties in order to re assess main factors impacting results, allowing thus to better identify cases for whom surgery is a possible alternative to IVF.