Implications of pattern of tubal disease for microsurgery or in vitro fertilization in Lagos.

Tubal disease was found in 78 of 100 consecutive Nigerian patients who had laparoscopy for infertility, while 22 patients had patent tubes. Forty-two patients had bilateral tubal occlusion; 18 had unilateral occlusion, while 18 had gross pelvic adhesions. Forty-one patients had cornual block, and 10 had hydrosalpinges. Multiparas were more prone to unilateral tubal occlusion or gross pelvic adhesions compared with nulliparas. In 27 (35 percent) patients with tubal disease in vitro fertilization (IVF) would be the only suitable treatment, while in another 10 (12 percent) patients with hydrosalpinges, IVF probably offers a better prognosis than microsurgery.