We analyzed the importance of 3 factors derived from the HSG (nature of the mucosal pattern, diameter of the hydrosalpinx, expandability of the ampulla) and of four factors from the findings at laparoscopy (extent of adhesions, nature of adhesions, thickness of tubal wall and diameter of the hydrosalpinx) for predicting the pregnancy outcome in 98 patients with bilateral hydrosalpinx. Each factor was categorized into 3 scores and each patient was scored for both the right and the left tube, resulting in 6 score-combinations. An association between the pregnancy prospects based on the score-combinations and the actual pregnancy outcome seemed to be present for all factors evaluated, except for the extent of adhesions and the diameter of the hydrosalpinx (laparoscopy). The results further indicate that a favourable score on the nature of mucosal pattern in one or both tubes concurs with good pregnancy prospects. In contrast, the presence of an unfavourable score for most of the other factors in at least one tube is associated with a poor fertility prognosis, regardless of the condition of the other tube.