Evaluation of subtle fallopian tube abnormalities in women with unexplained subfertility: a cross-sectional study

ABSTRACT
Objective. Non-obstructive lesions outside the fallopian tube are referred to as subtle distal fallopian tube abnormalities, such as tubal diverticula, Morgagni cyst, sacculation, accessory tube, accessory ostium, and fimbria agglutination. There is considerable evidence to suggest that these defects have a negative impact on fertility and may contribute to some cases of unexplained infertility. By implementing this adjustment for the treatment of tubal infertility, we can lower the incidence of “unexplained infertility,” which could lead to unnecessary IVF. to investigate the prevalence and types of subtle tubal abnormalities detected during laparoscopy in women with unexplained subfertility.
Patients and Methods. 120 women with unexplained infertility scheduled for diagnostic laparoscopy were included in the study. Evaluation of fallopian tubes is done by grasping the fimbria with non-traumatic forceps and thoroughly inspecting both sides for one or more of the abnormalities, followed by confirmation of tubal patency via chromopertubation.
Results. The prevalence of subtle tubal abnormalities diagnosed by laparoscopy was 58% (70/120). Positive laparoscopic findings were found bilaterally in 43 out of 70 (61.5%) women and unilaterally in 27 out of 70 (38.5%) women. Tubal sacculation was the most prevalent anomaly, at 47.14% (33 out of 70). Peritubal adhesions were significantly higher in women with subtle abnormalities; however, there was no statistical correlation between superficial endometriosis and the presence of these anomalies.
Conclusions. subtle tubal abnormalities have a high prevalence in women with unexplained infertility, and they may be linked to the etiology of subfertility in this population.