P-302 Salpingoscopy combined with methylene blue dye test for evaluating tubal conditions in hydrosalpinx patients and its correlation with post-salpingoplasty pregnancy outcomes

Study question Assessment of tubal conditions in hydrosalpinx patients using salpingoscopy and Methylene blue dye test: association with post-salpingoplasty pregnancy outcomes. Summary answer Salpingoscopic characteristics of hydrosalpinx patients pinpointing tubal risk factors for infertility, including methylene blue staining and the presence of foreign materials. What is known already To assess the efficacy of salpingoscopy in evaluating tubal conditions in patients diagnosed with hydrosalpinx, in conjunction with the methylene blue dye test, and to explore the correlation of these evaluations with pregnancy outcomes following salpingoplasty. The findings are intended to offer new insights into the diagnosis and management of infertility. Study design, size, duration A retrospective analysis was performed on a cohort of 146 infertile patients who underwent laparoscopy and salpingoscopy at Peking University People’s Hospital from Oct 2021 to Sep 2023.Clinical and pathological data were systematically collected, encompassing fallopian tube characteristics, patient age, obstetric history, preoperative levels of Anti-Müllerian Hormone (AMH), Follicle-Stimulating Hormone (FSH), carbohydrate antigen 125 (CA125), and pregnancy outcomes. Participants/materials, setting, methods All patients underwent salpingoscopy during laparoscopic procedures. The distal end of the hydrosalpinx was surgically opened to facilitate visualization. Observations during salpingoscopy were meticulously recorded, including the tubal mucosa, and the luminal adhesions, foreign materials, and other notable features. Following this, a 2.8% methylene blue dye was introduced, and the tube was re-evaluated after three minutes to assess dye uptake via salpingoscopy. Tubal conditions were quantified using a scoring system based on the aforementioned observations. Main results and the role of chance Among the 146 patients included, the pregnancy rate was 43.8% and the hydrosalpinx recurrence rate was 5.5%. Methylene blue staining of the fallopian tube was identified as a significant risk factor for postoperative infertility (Z = -3.208, P = 0.001). The presence of foreign material within the tube was significantly associated with preoperative infertility (Z = 0.494, P < 0.001). A positive correlation was observed between tubal mucosal scores and adhesion scores (r = 0.374, P < 0.001). Age was negatively correlated with preoperative AMH levels (r = -0.436, P < 0.001) but positively correlated with the number of prior pregnancies (r = 0.322, P < 0.001) and deliveries (r = 0.274, P = 0.001). FSH levels were positively correlated with tubal mucosal status (r = 0.300, P = 0.026), the presence of foreign material (r = 0.390, P = 0.003), and the overall tubal score (r = 0.334, P = 0.013). Conversely, AMH levels were negatively correlated with the overall tubal score (r = -0.246, P = 0.018). Limitations, reasons for caution However, further research with larger sample sizes and more comprehensive classifications of pregnancy outcomes is warranted to substantiate these findings. Wider implications of the findings This study elucidates the clinicopathological and salpingoscopic characteristics of infertile patients, pinpointing critical tubal risk factors for infertility, including methylene blue staining and the presence of foreign materials. Significant correlations were also established between age, hormonal profiles, tubal conditions, and pregnancy outcomes. Trial registration number No