The current place of tubal surgery in the management of subfertility

Abstract

Treatment of tubal disease can be challenging and complex. It requires accurate assessment of the extent of disease and evaluation of all fertility parameters. Although traditionally treatment involved salpingectomy or IVF or a combination of the two, less invasive treatment options may prove beneficial. We evaluated the various diagnostic tools for disease assessment and the treatment options available.

Keywords::

• Tubal disease
• subfertility
• management
• tubal surgery

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Hierarchy of evidence

	1aSystematic review and meta-analysis of randomised controlled trials.
1b	At least one randomised controlled trial.
2a	At least one well-designed, controlled study without randomisation.
2b	At least one other type of well-designed, quasi-experimental study.
3	Well-designed, nonexperimental descriptive studies, such as comparative studies, correlation studies or case studies.
4	Expert committee reports or opinions and/or clinical experience of respected authorities.

Grade strength of evidence

A.	ARequires at least one Randomised controlled trial (RCT) as part of a body of literature of overall good quality and consistency addressing the specific recommendation (Evidence levels 1a, 1b).
B.	Requires the availability of well controlled clinical studies but no randomised clinical trials on the topics of recommendations (Evidence levels 2a, 2b, 3).
C.	Requires evidence obtained from expert committee reports of opinions and/or clinical experiences of respected authorities. Indicates an absence of directly applicable clinical studies of good quality (Evidence level 4).

GPP, good practice point.