Indications to tubal reconstructive surgery in the era of IVF

In recent years, the treatment of tubal infertility has witnessed a shift from reconstructive surgery to in vitro fertilization. However, tubal surgery retains specific advantages, and appropriate preoperative evaluation allows improved selection of patients who are candidates for tubal reconstructive surgery by identifying the patients with good reproductive prognosis. Of pivotal importance in the selection of patients is the intratubal direct evaluation performed at salpingoscopy. Term pregnancy rates of approximately 70% and 65% may be obtained in patients with periadnexal adhesions and bilateral distal tubal occlusion, respectively, when a normal tubal mucosa is observed at salpingoscopy.