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Tubal Scoring System of Mage et al

Purpose: To evaluate a woman prior to performing microsurgery on the distal fallopian tube using the tubal score of Mage et al.

Description

Mage et al used a simple score describing a faloopian tube to predict the rates of intrauterine and ectopic pregnancy following distal tubal microsurgery. This can help to decide whether to proceed with microsurgery or to consider in vitro fertilization. The authors are from Universite de Clermont-Ferrand in France.


Parameters:

(1) tubal patency

(2) ampullar tubal mucosa (hysterosalpingogram, HSG)

(3) ampullar tubal wall (on laparoscopy)

 

Parameter

Finding

Points

tubal patency

patent

0

 

partial occlusion

2

 

total occlusion (hydrosalpinx)

5

ampullar tubal mucosa

normal

0

 

decreased folds

5

 

honeycomb

10

 

no folds

10

ampullar tubal wall

normal

0

 

thin

5

 

thick and/or rigid

10

 

tubal score =

= SUM(points for all 3 parameters)

 

Interpretation:

• minimum score: 0 (probably not a candidate for tubal microsurgery)

• maximum score: 25

• The higher the tubal score the greater the problems with fertility.

• If the scores for the left and right fallopian tubes differ, then the lower score is used.

• Adding an assessment of adhesions (none to severe) improved the ability to predict outcome. A patient with a normal tubal score and no adhesions had the highest rate of successful intrauterine pregnancy.

• In vitro fertilization should be considered for a patient with a high tubal score and adhesions.

 

Tubal score

Grade

0

0

2 to 5

I

7 to 10

II

12 to 15

III

17 to 25

IV

 


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Specialty

Objective

ICD-10