Impact of the learning curve on term delivery rates following laparoscopic salpingostomy for infertility associated with distal tubal occlusive disease

The objective of this study was to determine the impact of the learningcurve of one surgeon on the term delivery rate following laparoscopicsalpingostomy for tubal infertility. This was a retrospective audit ofongoing clinical practice, undertaken in two tertiary level infertilityprogrammes. Subjects in this study were women undergoing surgery for totalocclusion of the distal Fallopian tube. The main outcome measure wascumulative term delivery rates. On stepwise life-table analysis the lengthof infertility, primary and secondary infertility, tubal diameter andwhether surgery was performed in the first or second half of the serieswere significantly associated with outcome. These data suggest that thereis a learning curve in obtaining skills to perform laparoscopicsalpingostomy, that patient selection may improve with experience, and thatselection criteria should be emphasized during didactic teaching and thepreceptorship process.