Salpingoscopy.

PURPOSE OF REVIEW: Salpingoscopy is an endoscopic technique that allows direct evaluation of the ampullary tubal mucosa at the time of laparoscopy. It has been reported that the presence of ampullary mucosal adhesions can negatively affect reproductive outcome and increase the risk of ectopic tubal pregnancy. Various studies have suggested that the extent of intra-luminal adhesions may not correlate with the nature and extent of periadnexal adhesions.

RECENT FINDINGS: Further studies on salpingoscopic and laparoscopic correlations with regard to fertility outcome have been reported in the literature. Recently microsalpingoscopy has been introduced, with the number of nuclei stained by methylene blue dye employed as a prognostic factor of conception in women with infertility. As an alternative to salpingoscopy performed during laparoscopy, which requires hospitalization and general anesthesia, two groups have described salpingoscopy as an office procedure performed during transvaginal hydrolaparoscopy or in conjunction with fertiloscopy.

SUMMARY: The prognostic value of salpingoscopy during operative laparoscopy for tubal factor infertility in terms of reproductive outcome has been confirmed. The prognostic significance of microsalpingoscopy needs further validation in large-scale clinical trials. Transvaginal hydrolaparoscopy and fertiloscopy appear to be an alternative to hysterosalpingography as a first line procedure to investigate female infertility.