Fertiloscopy

In: Infertility and Assisted Reproduction · 2008 · pp. 70–75 · doi:10.1017/cbo9780511547287.010 · W182209921
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Fertiloscopy is an ambulatory procedure comprising five steps that offers advantages over laparoscopy, including low complication rates and effectiveness in treating minimal endometriosis and PCOS.

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Abstract

Fertiloscopy is performed as an ambulatory technique. There are five steps in this procedure: hydropelviscopy, dye test, salpingoscopy, microsalpingoscopy, and hysteroscopy. One of the prerequisite of operative fertiloscopy was to be as effective as the same procedure practiced during laparoscopy. Compared to laparoscopy, fertiloscopy has also some advantages like the facility to perform salpingoscopy and microsalpingoscopy. Fertiloscopy was first designed to avoid diagnostic laparoscopy. Operative possibilities were developed later. The complication rate is low, almost always avoidable if contraindications are strictly respected. Endometriosis may also be treated by operative fertiloscopy, when minimal or moderate. If the lesions are extensive or severe, then laparoscopy has to be the preferred option. Some techniques like fertiloscopic ovarian drilling in polycystic ovarian syndrome (PCOS) patients have already demonstrated its interest in the pregnancy rate obtained without the risks of ovarian hyperstimulation syndrome (OHSS).
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- 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 from PART II - INFERTILITY EVALUATION AND TREATMENT Published online by Cambridge University Press: 04 August 2010 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 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). - Type - Chapter - Information - Infertility and Assisted Reproduction , pp. 70 - 75Publisher: Cambridge University PressPrint publication year: 2008 The accuracy of hysterosalpingography in the diagnosis of tubal pathology: a meta-analysis. Fertil. Steril. 1995, 64, 486–91.CrossRefGoogle Scholar , , , et al. Surgical complications of diagnostic and operative gynaecologic laparoscopy: a serie of 29966 cases. Hum. Reprod. 1999, 13, 867–72.CrossRefGoogle Scholar , , , et al. Actualisation de la culdoscopie transvaginale en décubitus dorsal. Un nouvel endoscope à vision directe muni d'une aiguille à ponction incorporée dans l'axe. Contr. Fertil. Sex 1987, 15, 401–4.Google Scholar . . Transvaginal hydrolaparoscopy as an outpatient procedure for infertility investigation. Hum. Reprod. 1998, 13, 99–103.CrossRefGoogle ScholarPubMed , , , . Office hydrolaparoscopy for the diagnosis of endometriosis and tubal infertility. Curr. Opin. Obstet. Gynec. 1999, 11, 371–7.CrossRefGoogle Scholar , , . , , , . Fertiloscopy; first results (120 cases report). Fertil. Steril. 1998, 70 (Suppl.), S 42.Google Scholar , , . Evaluation of the performance of fertiloscopy in 160 consecutive infertile patients with no obvious pathology. Hum. Reprod. 1999, 14, 3, 707–11.CrossRefGoogle ScholarPubMed , , . Methylene blue dyeing of cellular nuclei during salpingoscopy, a new in vivo method to evaluate vitality of tubal epithelium. Hum. Reprod. 1998, 13, 3414–17.CrossRefGoogle ScholarPubMed , . , . Risk and outcome of bowel injury during transvaginal pelvic endoscopy. Fertil. Steril. 2001, 76, 1238–41.CrossRefGoogle ScholarPubMed , , , . A propos de deux complications au cours du drilling ovarien par fertiloscopie. Gynecol. Obstet. Fertil. 2003, 31, 844–6.CrossRefGoogle Scholar , , , . Is laparoscopy still the gold standard in infertility assessment? A comparison of fertiloscopy versus laparoscopy in infertility. Hum. Reprod. 2003, 18, 834–9.CrossRefGoogle ScholarPubMed , , , , . Microendoscopy of the human fallopian tube. J. Am. Assoc. Gynaec. Laparosc. 1999, 6(4), 383–90.CrossRefGoogle ScholarPubMed . Explorations intra-tubaires au cours de la fertiloscopie. Reprod. Hum. et Horm. 2000, 12, 39–44.Google Scholar , . Manual of Ovulation Induction. Mumbai: India, Rotunda Medical Technologies, 2001, chapter, 140–4.Google Scholar ., Laparoscopic ovarian drilling for ovulation induction in polycystic ovarian syndrome. In . (Ed.) 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Find out more about the Kindle Personal Document Service. - Fertiloscopy - - Book: Infertility and Assisted Reproduction - Online publication: 04 August 2010 To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox. - Fertiloscopy - - Book: Infertility and Assisted Reproduction - Online publication: 04 August 2010 To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive. - Fertiloscopy - - Book: Infertility and Assisted Reproduction - Online publication: 04 August 2010

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endometriosis

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