Book contents
- Frontmatter
- Contents
- Contributors
- Foreword
- Preface
- Introduction
- PART I PHYSIOLOGY OF REPRODUCTION
- PART II INFERTILITY EVALUATION AND TREATMENT
- 6 Evaluation of the Infertile Female
- 7 Fertiloscopy
- 8 Microlaparoscopy
- 9 Pediatric and Adolescent Gynecologic Laparoscopy
- 10 Laparoscopic Tubal Anastomosis
- 11 Tubal Microsurgery versus Assisted Reproduction
- 12 The Future of Operative Laparoscopy for Infertility
- 13 Operative Hysteroscopy for Uterine Septum
- 14 Laser in Subfertility
- 15 Ultrasonography of the Endometrium for Infertility
- 16 Ultrasonography of the Cervix
- 17 Transrectal Ultrasonography in Male Infertility
- 18 The Basic Semen Analysis: Interpretation and Clinical Application
- 19 Evaluation of Sperm Damage: Beyond the WHO Criteria
- 20 Male Factor Infertility: State of the ART
- 21 Diagnosis and Treatment of Male Ejaculatory Dysfunction
- 22 Ovulation Induction
- 23 Clomiphene Citrate for Ovulation Induction
- 24 Aromatase Inhibitors for Assisted Reproduction
- 25 Pharmacodynamics and Pharmacokinetics of Gonadotrophins
- 26 The Future of Gonadotrophins: Is There Room for Improvement?
- 27 Ovarian Hyperstimulation Syndrome
- 28 Reducing the Risk of High-Order Multiple Pregnancy Due to Ovulation Induction
- 29 Hyperprolactinemia
- 30 Medical Management of Polycystic Ovary Syndrome
- 31 Surgical Management of Polycystic Ovary Syndrome
- 32 Endometriosis-Associated Infertility
- 33 Medical Management of Endometriosis
- 34 Reproductive Surgery for Endometriosis-Associated Infertility
- 35 Congenital Uterine Malformations and Reproduction
- 36 Unexplained Infertility
- 37 “Premature Ovarian Failure”: Characteristics, Diagnosis, and Management
- PART III ASSISTED REPRODUCTION
- PART IV ETHICAL DILEMMAS IN FERTILITY AND ASSISTED REPRODUCTION
- Index
- Plate section
- References
7 - Fertiloscopy
from PART II - INFERTILITY EVALUATION AND TREATMENT
Published online by Cambridge University Press: 04 August 2010
- Frontmatter
- Contents
- Contributors
- Foreword
- Preface
- Introduction
- PART I PHYSIOLOGY OF REPRODUCTION
- PART II INFERTILITY EVALUATION AND TREATMENT
- 6 Evaluation of the Infertile Female
- 7 Fertiloscopy
- 8 Microlaparoscopy
- 9 Pediatric and Adolescent Gynecologic Laparoscopy
- 10 Laparoscopic Tubal Anastomosis
- 11 Tubal Microsurgery versus Assisted Reproduction
- 12 The Future of Operative Laparoscopy for Infertility
- 13 Operative Hysteroscopy for Uterine Septum
- 14 Laser in Subfertility
- 15 Ultrasonography of the Endometrium for Infertility
- 16 Ultrasonography of the Cervix
- 17 Transrectal Ultrasonography in Male Infertility
- 18 The Basic Semen Analysis: Interpretation and Clinical Application
- 19 Evaluation of Sperm Damage: Beyond the WHO Criteria
- 20 Male Factor Infertility: State of the ART
- 21 Diagnosis and Treatment of Male Ejaculatory Dysfunction
- 22 Ovulation Induction
- 23 Clomiphene Citrate for Ovulation Induction
- 24 Aromatase Inhibitors for Assisted Reproduction
- 25 Pharmacodynamics and Pharmacokinetics of Gonadotrophins
- 26 The Future of Gonadotrophins: Is There Room for Improvement?
- 27 Ovarian Hyperstimulation Syndrome
- 28 Reducing the Risk of High-Order Multiple Pregnancy Due to Ovulation Induction
- 29 Hyperprolactinemia
- 30 Medical Management of Polycystic Ovary Syndrome
- 31 Surgical Management of Polycystic Ovary Syndrome
- 32 Endometriosis-Associated Infertility
- 33 Medical Management of Endometriosis
- 34 Reproductive Surgery for Endometriosis-Associated Infertility
- 35 Congenital Uterine Malformations and Reproduction
- 36 Unexplained Infertility
- 37 “Premature Ovarian Failure”: Characteristics, Diagnosis, and Management
- PART III ASSISTED REPRODUCTION
- PART IV ETHICAL DILEMMAS IN FERTILITY AND ASSISTED REPRODUCTION
- Index
- Plate section
- References
Summary
Reproductive medicine is now mainly in the hands of nonsurgical doctors. Several reasons may explain this fact: first of all, the success of IVF and therefore the decreasing of surgical indications especially in tubal surgery and then the fact that, since 1986, egg collection is performed through ultrasonography and so requires no surgical skill.
Indeed, it is was a major progress to be able to perform IVF procedure without the need of laparoscopy, but as a consequence, reproductive surgery was progressively abandoned even at the stage of diagnosis. Therefore, today, very frequently, only noninvasive methods like hysterosalpingography (HSG) or ultrasonography are used to assess the normality of the genitalia.
Using only nonsurgical method of diagnosis leads to a false-negative rate between 20 and 40 percent, according to the works published. Swart et al. (1) in a meta-analysis found for HSG a point estimate of 0.65 for sensitivity and of 0.83 for specificity and underline the fact that HSG was not suitable for the evaluation of periadnexal adhesions.
In contrast, laparoscopy is considered as the gold standard to explore tuboperitoneal infertility. Nevertheless, laparoscopy is often performed without discovering any significant pathology.
Unfortunately, laparoscopy presents some risks that can be very serious, as recently shown in the French register of laparoscopic accidents, where six major injuries occurred in diagnostic laparoscopies (2).
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- Infertility and Assisted Reproduction , pp. 70 - 75Publisher: Cambridge University PressPrint publication year: 2008