Laparoscopic salpingostomy: fertility results according to the tubal mucosal appearance.

Prognostic factors for fertility outcome following laparoscopic salpingostomy were evaluated. We studied all distal tuboplasties performed between May 1986 and June 1991. Ninety infertile women were treated. Tuboplasty was carried out bilaterally except when one tube was absent or when bifocal lesions were present. Salpingostomy was performed using either scissors and thermocoagulation for eversion, or the CO2 laser. Cumulative pregnancy rates were evaluated by life-table analysis, according to the tubal classification and the mucosal status. The 18 months estimated cumulative pregnancy rate with normal delivery was 28.7%. Pregnancy rates were significantly higher in patients classified in grades I and II versus grade III and IV (severely damaged tubes) according to the distal tubal scoring system, and in patients with normal or lightly atrophic mucosa versus alveolar or absent mucosa. Operative laparoscopy is effective for treatment of hydrosalpinges. Fertility outcome is related to the tubal damage. Our results demonstrate that the prognosis value of the mucosal status seems to be as predictive as the distal tubal scoring system.