ABSTRACT
Background: More than 70 million couples suffer from infertility worldwide. The aim of this study was to evaluate the fertility outcomes after laparoscopic fimbrioplasty and neosalpingostomy in female infertility
Methods: Laparoscopic distal tuboplasty was carried out for 402 cases at the Gynecological Endoscopic Surgery and Human Reproductive Teaching Hospital in Yaounde-Cameroon in Central Africa from December 2002 to December 2007. Laparoscopic fimbrioplasty and neosalpingostomy were done using bipolar electrocoagulation and conventional endoscopic instruments. Log-rank test was used to compare cumulative rate curves of intrauterine pregnancy with respect to the tubal stages. P<0.05 was considered statistically significant
Results: The mean age of the patients was 31.6 +/- 5.45 years. Secondary infertility was the most frequent type of infertility [70.14%]. The laparoscopic tubal surgery done consisted of fimbrioplasty in 185[46%] cases and neosalpingostomy in 217 [54%] cases. Of 260 women followed up after tuboplasty, there were overall 74 [28.48%] pregnancies; 68[26.1%] intrauterine pregnancies and 6[2.3%] ectopic pregnancies. Pregnancy rates were significantly associated to the tubal stage [63% in stage 1, 15% in stage 3 and 00% in stage 4; p<0.001] and the adnexal adhesion scores [73.91% in the absence of adnexal adhesions and 8.8% in the case of a severe adnexal adhesion score]. Of the 68 intrauterine pregnancies, there were 60[88%] live births and 8[12%] spontaneous abortions
Conclusion: It is believed that laparoscopic fimbrioplasty and neosalpingostomy should be the preferred choice when faced with tubal distal occlusion in a context of female infertility. This implies that training in endoscopic surgery should be regarded as an important issue in developing countries