• Surgery can be useful in selected cases of tubal infertility and may have a complementary role for some women undergoing in vitro fertilisation (IVF). • Salpingectomy for women with large hydrosalpinges can improve the success rate of IVF. • There is little evidence that laparoscopy offers any advantage over laparotomy for tubal surgery. • Structured training in reproductive surgical techniques is of critical importance. Learning objectives: • To understand the selection criteria for tubal surgery and evaluate the supporting evidence. • To understand the limitations of the existing evidence. • To be able to counsel infertile couples appropriately. Ethical issues: • Couples seeking fertility treatment may receive unreliable or biased information when considering tubal surgery. • Is it ethical to perform tubal surgery on women with a low chance of success simply because they are unable to have IVF? Please cite this article as: Siassakos D, Syed A, Wardle P. Tubal disease and assisted reproduction. The Obstetrician & Gynaecologist 2008;10:80–87.
