Results of microsurgical reconstruction in patients with combined proximal and distal tubal occlusion: double obstruction.

Thirty-one patients underwent microsurgery for correction of postinflammatory occlusion of both the proximal and the distal portions of the oviduct. Preoperative staging of tubo-ovarian adhesions, hydrosalpinges, and sites of oviductal occlusion was completed in each patient. Laparoscopic records were reviewed to correlate laparoscopic sites of occlusion with those found at the time of microsurgery. The conception rate at 2.5 years of observation was 12%, and there were no live births. The sensitivity of laparoscopy to predict proximal and distal disease was 65.6 and 55.2%, respectively. The poor surgical outcome in these patients suggests that IVF-ET should be strongly considered and that a careful preoperative laparoscopic examination is necessary for prospective counseling in these patients.