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12 - The Future of Operative Laparoscopy for Infertility

from PART II - INFERTILITY EVALUATION AND TREATMENT

Published online by Cambridge University Press:  04 August 2010

By
Camran Nezhat  and
Bulent Berker
Edited by
Botros R. M. B. Rizk ,
Juan A. Garcia-Velasco ,
Hassan N. Sallam  and
Antonis Makrigiannakis
Botros R. M. B. Rizk
Affiliation:
University of South Alabama
Juan A. Garcia-Velasco
Affiliation:
Rey Juan Carlos University School of Medicine,
Hassan N. Sallam
Affiliation:
University of Alexandria School of Medicine
Antonis Makrigiannakis
Affiliation:
University of Crete
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Summary

CURRENT TRENDS

There is little consensus regarding the composition of the ideal evaluation of the couple experiencing infertility. Validation of the most cost-effective, productive, and minimally invasive means of completing the infertility evaluation is an evolving art requiring a critical eye, willingness to learn new techniques, and a desire to best serve the interests of our patients. A diagnosis of unexplained infertility is usually made only after it has been demonstrated that the female partner ovulates regularly, has patent Fallopian tubes, shows no evidence of peritubal adhesions, fibroids or endometriosis, and has a partner with normal sperm production and function. Only when all standard clinical investigations yield normal results should the diagnosis of unexplained infertility be raised (1). This means that for an optimal evaluation of an infertile woman, optimal assessment of the morphology of the pelvic cavity, uterus, and the tubes demands the utilization of laparoscopy. The principal options for the evaluation of the morphology of the uterus and tubes are hysterosalpingography (HSG) and laparoscopy with hydrotubation. The two techniques are complementary, but there is considerable pressure to simplify the investigation and the cost/benefit calculation tends to favor hysterosalpingography (2). Whereas, one should keep in mind that, in infertile couples, laparoscopy reveals abnormal findings in twenty one to sixty eight percent of cases with a normal HSG (3).

Keywords

artificial reproductive technologydiagnostic laparoscopyendometriosishydrosalpinxleiomyomaoperative laparoscopyinfertility
Type
Chapter
Information
Infertility and Assisted Reproduction , pp. 107 - 114
Publisher: Cambridge University Press
Print publication year: 2008

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