Redefining reproductive surgery

Journal of Minimally Invasive Gynecology
Togas Tulandi, Alicia Marzal

Abstract

With the availability of and improvements in in vitro fertilization (IVF), the role of reproductive surgery has been questioned. Yet, the scope of reproductive surgery today is much larger than in the past. Hysteroscopic correction of intrauterine disease is an important endoscopic procedure in women with infertility. Evidence suggests that correction of intrauterine disease is often followed by spontaneous pregnancy and improved IVF outcome. Hysteroscopic examination should be considered after 1 failed IVF. Today, it is clear that removal of the hydrosalpinx leads to a higher IVF-related live birth rate. The procedure should be performed thoroughly without compromising the ovarian blood supply. The IVF pregnancy rate is not affected by the presence of ovarian endometriomas, and small endometriomas need not be removed; however, large and symptomatic endometriomas that interfere with oocyte retrieval should be excised. When excision of the cyst wall is difficult, fenestration and ablation should be considered. This might lead to an increased recurrence rate, but is associated with less interference of the ovarian reserve. Although the role of reproductive surgery as primary treatment for tuboperitoneal infertility is limited, it...Continue Reading

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Aug 14, 2012·Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology·Andrea R Genazzani
Aug 2, 2012·Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology·Antonio MalvasiAndrea Tinelli
May 28, 2013·Journal of Minimally Invasive Gynecology·Yu-Ju LinKuo-Chung Lan
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Dec 3, 2014·Journal of Minimally Invasive Gynecology·Togas Tulandi
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Apr 21, 2021·Reproductive Sciences·Sivanandane SittadjodyJames J Yoo

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