| Tubal congenital anomalies |
Partial or segmental absence solution: in vitro fertilization with good results [11] |
Duplication recommended surgical excision [6] |
Multiple lumina and diverticula are rarely associated with primary infertility [10] |
| Due to the absence of any clinical signs, making a diagnosis of fallopian tube anomalies ahead of surgery may be very challenging. Some authors recommended surgical excision of accessory ostium in order to improve reproductive outcomes and prevent complications. The result of In vitro fertilization success for patients with no other found cause of infertility was significantly high in all tubal congenital anomalies [10] |
| Paraovarian and paratubal cysts |
Hydatids of Morgagni |
Paraovarian cysts |
| Distinguishing between ovarian and paraovarian cysts can be challenging. They act as an obstacle near the fimbria in picking up the ovum; extirpation of these cysts improves ovum pick-up and enhances fertility [13,14] |
| Pelvic inflammatory disease |
Nearly 20% of patients with pelvic inflammatory disease would experience infertility issues [15]. Grades of pelvic inflammatory disease have an adverse effect on In vitro fertilization outcomes. Receiving salpingectomy or not should be based on different grades of pelvic inflammatory disease [18] |
Tubo-ovarian abscess: Once diagnosed, in order to preserve the ovarian function and resolve the case quickly, laparoscopic intervention is preferred over conservative management with a resolution of 90-100% compared to 20-87% [28,30] |
| Pelvic inflammatory disease is considered to be the primary cause of tubal adhesions and acquired abnormalities [29] |
| Salpingitis isthmica nodosa |
There is no conservative treatment for salpingitis isthmica nodosa [37]. Tubocornual anastomosis can be attempted with a good result in fertility if the resected segment is less than 1 cm [39,40]. In vitro fertilization has good results, by the 5th cycle 80% of live birth |
| Hydrosalpinx |
Hydrosalpinx fluid has embryotoxic properties, which is why salpingectomy is recommended before In vitro fertilization [45]. Within two years following neosalpingostomy for hydrosalpinx, the natural pregnancy rate for mild, moderate, and severe hydrosalpinx was 50%, 17%, and 15%, respectively [48]. In fact, assisted reproductive technology and integrated hydrosalpinx treatment result in a 61% cumulative pregnancy rate [50] |
| Tubal endometriosis |
Additional to pelvic adhesions, endometriosis comes with an additional inflammation package in the pelvis [54]. In some cases, surgery can have a positive impact on pregnancy rates [56] |
| Ectopic pregnancy |
After an ectopic pregnancy, the uterine pregnancy rate was 52%. The repeat ectopic pregnancy rate was 12.6% [63]. Expectant conduct seems to have the most favorable results in the long term on fertility [68]. Salpingectomy has advantages over salpingostomy in patients classified as low-risk. Salpingostomy is preferable in women with risk factors for tubal disease [65] |
