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.