Effectiveness of laparoscopic tubal anastomosis in tubal occlusion patients after laparoscopic salpingostomy for tubal pregnancy

Abstract

To evaluate the effectiveness of laparoscopic tubal anastomosis for tubal occlusions associated with infertility in patients with prior laparoscopic salpingostomy for ectopic pregnancy. This study is a retrospective analysis of the pregnancy outcomes of 173 infertile patients who underwent hysteroscopy and laparoscopic tubal anastomosis treatment between January 2013 and August 2018 in the Department of Reproductive Endocrinology in West China Second University Hospital of Sichuan University. All patients had a history of laparoscopic salpingostomy for tubal pregnancy. The primary outcomes were intrauterine pregnancy (IUP), ectopic pregnancy (EP), and delivery (DEL) rates. We further studied the associated factors that could influence the chance in pregnancy status. The 24-month cumulative clinical pregnancy rate of all patients was 107/173 (61.8%). The distribution of outcomes for the entire group of pregnancies was as follows: IUP rate, 76/173 (43.9%); EP rate, 31/173 (17.9%); DEL rate, 68/173 (39.3%); and miscarriage rate, 8/173 (4.6%). Age, type of anastomosis, hydrosalpinx, and endometrial polyp were significant prognostic factors in the multivariate model. Laparoscopic tubal anastomosis is an effective treatment for tubal-associated infertility due to previous laparoscopic salpingostomy for ectopic pregnancy, especially for patients under 35 years of age.