Laparoscopic surgery in the preparation of patients for assisted reproductive technology

Abstract

Objective and methods: Laparoscopy and hysteroscopy were carried out in 37 patients following unsuccessful attempts at IVF since 1995. The following abnormalities were diagnosed: bilateral sapingitis - 18 cases, external genital endometriosis - 15, endometrial pathology - 10, uterine myoma - 5 and combined pathology - 24.

Full Text

Results: Bilateral salpingoectomy is recommended in patients having large size hydrosalpingitis with inflammatory reaction. This helps in reducing the incidence of unsuccessful cases of ART as well as protects patients from developing a frequent complication of ART - tubal pregnancy. Salpingostomy together with surgical sterilization is the best method of preparing patients for ART in the older reproductive age group with a long history of pelvic inflammatory disease in the presence of salpingitis.

Conclusions: Even in the abscence of intrauterine pathology by HSG and echography it is recommended to do hysteroscopy with fractional D&C before carrying out IVF; in more than 1/3 of these cases endometrial pathology is diagnosed.