Fallopian Tube Reconstruction Workup

Updated: Nov 30, 2016
  • Author: Krystene B DiPaola, MD; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
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Workup

Laboratory Studies

Male factors

See the list below:

  • Men account for 30-40% of infertility in couples.

  • Problems typically include low semen volume, decreased sperm concentration and/or motility, and abnormal sperm morphology.

  • Semen analysis is necessary.

Female factors

In some women, ovulatory problems are a cause of infertility. Ovulatory function tests can help determine ovulatory function. Adequate ovulatory function can be confirmed with the following:

  • Normal regular menstrual cycles

  • Day 3 follicle-stimulating hormone level within the reference range

  • Anti-mullerian hormone level

  • Midluteal-phase serum progesterone measurement confirmatory of ovulation

Papanicolaou test (Pap smear) results must be normal.

Cervical culture results (eg, C trachomatis, N gonorrhea) must be negative.

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Imaging Studies

Hysterosalpingography may be used to determine the presence of proximal fallopian tubes.

When necessary, saline sonography further defines abnormalities of the uterine cavity.

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Other Tests

Basal body temperature charting can help identify female ovulatory factors.

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Diagnostic Procedures

Laparoscopy

  • This procedure helps to (1) evaluate the amount of pelvic adhesions and tubal damage before tubal reconstructive surgery; (2) measure the diameter of a hydrosalpinx to determine the feasibility of tubal reconstruction; and (3) identity the distal portion of the fallopian tube(s) prior to tubal anastomosis following sterilization procedures.

  • This procedure also facilitates estimation of the length of the tube resulting from the tubal reconstructive surgery.

  • Tubal and pelvic reconstruction can be performed with the patient under the same anesthesia following diagnostic laparoscopy, via operative laparoscopy, or via laparotomy when necessary. However, patients may request a different surgical procedure on a different day if a laparotomy is required.

Timed endometrial biopsy can help identify female ovulatory factors.

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