The present study reviews the pregnancy outcome in 52 patients treated with uterotubal implantation for intramural or isthmic obstruction. Twenty-six patients were treated with the sharp cornual wedge technique, four of whom conceived for a pregnancy rate of 15%. Within this group, 20 patients had the isthmic portion and 6 patients had the ampullary portion of the fallopian tube implanted into the uterus. The pregnancy rates were 15% and 17%, respectively. An additional 26 patients were treated by the reamer technique, 11 of whom (42%) conceived. Of the 26 patients treated with the reamer technique, 15 had the isthmic portion of the fallopian tube implanted into the uterus and 11 patients had the ampullary portion of the fallopian tube implanted. Pregnancy rates were 27% and 64%, respectively. Over-all, 52 patients were treated with uterotubal implantation, 15 of whom conceived for a pregnancy rate of 29%. Eight patients (15%) had pregnancies which resulted in living children. The reamer technique (implanting the ampullary portion of the fallopian tube) appeared to give the best results in achievement of pregnancy, although this did not reach a level of statistical significance. Adhesion formation involving the fallopian tube and ovary noted at the time of uterotubal implantation was categorized according to a classification based on the extent and the site of the adhesion formation. Pregnancy was less likely to occur in those patients with fixation of the ovary and tube and obliteration of the cul-de-sac (P<0.05).