laparoscopic fimbrioplasty and neosalpingostomy in female infertility: a review of 402 cases at the gynecological endoscopic surgery and human reproductive teaching hospital in yaoundé-cameroon

background: more than 70 million couples suffer from infertility worldwide. the aim of this study was to evaluate the fertility outcomes after laparoscopic fimbrioplasty and neosalpingostomy in female infertility. methods: laparoscopic distal tuboplasty was carried out for 402 cases at the gynecological endoscopic surgery and human reproductive teaching hospital in yaoundé-cameroon in central africa from december 2002 to december 2007. laparoscopic fimbrioplasty and neosalpingostomy were done using bipolar electrocoagulation and conventional endoscopic instruments. log-rank test was used to compare cumulative rate curves of intrauterine pregnancy with respect to the tubal stages. p<0.05 was considered statistically significant. results: the mean age of the patients was 31.6±5.45 years. secondary infertility was the most frequent type of infertility (70.14%). the laparoscopic tubal surgery done consisted of fimbrioplasty in 185(46%) cases and neosalpingostomy in 217(54%) cases. of 260 women followed up after tuboplasty, there were overall 74(28.48%) pregnancies; 68(26.1%) intrauterine pregnancies and 6(2.3%) ectopic pregnancies. pregnancy rates were significantly associated to the tubal stage (63% in stage 1, 15% in stage 3 and 00% in stage 4; p<0.001) and the adnexal adhesion scores (73.91% in the absence of adnexal adhesions and 8.8% in the case of a severe adnexal adhesion score). of the 68 intrauterine pregnancies, there were 60(88%) live births and 8(12%) spontaneous abortions. conclusion: it is believed that laparoscopic fimbrioplasty and neosalpingostomy should be the preferred choice when faced with tubal distal occlusion in a context of female infertility. this implies that training in endoscopic surgery should be regarded as an important issue in developing countries.