Role of transvaginal hydrolaparoscopy in the management of the infertile patient

Transvaginal hydrolaparoscopy (THL) was introduced in the evaluation of infertility to explore the pelvic structures in their natural positions. In our clinical experience, THL was performed in 93.3.% of cases with no complication. The overall accuracy of THL in diagnosis of pelvic pathology was 81.8%. More recently, some interventions during THL were reported. We treated 28 clomiphene-resistant, anovulatory women with polycystic ovary syndrome by transvaginal hydrolaparoscopic ovarian drilling using the bipolar VersaPoint system. In conclusion, THL can be proposed as a first line procedure in the routine evaluation of infertile women without clinical or imaging evidence of pelvic disease. Also the surgical treatment can be realized by this technique, when required. Further clinical trials need to elucidate the precise role of THL in the evaluation and management of infertility.