Management of tubal factor

Management of tubal factor in infertility is important to consider even if in vitro fertilization (IVF) represents a major breakthrough, as it has dwarfed the role of tubal surgery. We believe there is still a place for tubal surgery to provide diagnostics if selection of cases is accurate. Classification of lesions is important, especially a focus on subtle tubal lesions. Considered to not have any detrimental effect on fertility, it appears that these lesions have much more importance that previously thought. Tubal surgery today is essentially distal surgery practised by laparoscopy or proximally (in case of sterilization reversal) by laparoscopy or robotic surgery. Providing that an accurate selection is made, when operating on “good” cases, a well-trained surgeon may expect fertility results comparable to IVF results, which gives a place for tubal surgery among the fertility tools.