Is laparoscopy necessary before assisted reproductive technology?

C. Tamer Erel, Levent M Senturk, Levent M. Şentürk
Current opinion in obstetrics & gynecology · 2005 · vol. 17(3) , pp. 243–248 · doi:10.1097/01.gco.0000169100.75719.62 · PMID:15870557 · W2091548223
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This review examines when laparoscopy is beneficial before assisted reproductive technology, noting it's indicated for visible hydrosalpinges, selected polycystic ovary syndrome patients, and cancer survivors needing ovary repositioning.

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⚙ AI-generated deep summary by qwen3.7-flash, 2026-08-21 · read from full text ⓘ

This review evaluates the necessity of laparoscopy prior to assisted reproductive technology cycles, noting that surgical treatment of pelvic adhesions or endometriosis does not improve pregnancy rates. The authors identify specific scenarios where intervention is beneficial, such as salpingectomy for bilateral hydrosalpinges, ovarian drilling for severe hyperstimulation risk in polycystic ovary disease, and repositioning ovaries in cancer survivors. Laparoscopy is recommended only when it simultaneously diagnoses and treats pathology that enhances subsequent fertility outcomes. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

PURPOSE OF REVIEW: Laparoscopy is widely used during infertility work-up, although it is sometimes unnecessary. This review highlights when laparoscopic intervention should be used in women undergoing assisted reproductive technology cycles. RECENT FINDINGS: There is no evidence for an increase in pregnancy rates in assisted reproductive technology cycles following surgical treatment of pelvic adhesions or endometriosis with laparoscopy. If the patient has bilateral visible hydrosalpinges, laparoscopy may be an option for evaluation of the tubes and treatment with salpingectomy in order to enhance the chance of pregnancy before commencing an assisted reproductive technology cycle. Laparoscopic ovarian drilling before assisted reproductive technology may be considered a therapeutic option in polycystic ovary disease patients who previously had severe ovarian hyperstimulation syndrome. Finally, laparoscopy may be useful in replacing the transposed ovaries to their original sites in the pelvic cavity in previously treated cancer patients so that monitoring of the controlled ovarian hyperstimulation and the oocyte aspiration would be much easier during the assisted reproductive technology cycles. SUMMARY: Laparoscopy should be considered before assisted reproductive technology cycles if the procedure diagnoses and treats a pelvic pathology at the same time and if laparoscopic intervention increases the chance of pregnancy following these cycles.
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Is laparoscopy necessary before assisted reproductive technology? - C Tamer Erel - Levent M Senturk Purpose of review Laparoscopy is widely used during infertility work-up, although it is sometimes unnecessary. This review highlights when laparoscopic intervention should be used in women undergoing assisted reproductive technology cycles. Recent findings There is no evidence for an increase in pregnancy rates in assisted reproductive technology cycles following surgical treatment of pelvic adhesions or endometriosis with laparoscopy. If the patient has bilateral visible hydrosalpinges, laparoscopy may be an option for evaluation of the tubes and treatment with salpingectomy in order to enhance the chance of pregnancy before commencing an assisted reproductive technology cycle. Laparoscopic ovarian drilling before assisted reproductive technology may be considered a therapeutic option in polycystic ovary disease patients who previously had severe ovarian hyperstimulation syndrome. Finally, laparoscopy may be useful in replacing the transposed ovaries to their original sites in the pelvic cavity in previously treated cancer patients so that monitoring of the controlled ovarian hyperstimulation and the oocyte aspiration would be much easier during the assisted reproductive technology cycles. Summary Laparoscopy should be considered before assisted reproductive technology cycles if the procedure diagnoses and treats a pelvic pathology at the same time and if laparoscopic intervention increases the chance of pregnancy following these cycles.

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Condition tags

endometriosisinfertility

MeSH descriptors

Infertility, Female Laparoscopy Reproductive Techniques, Assisted Endometriosis Endometriosis Endometriosis Fallopian Tube Diseases Fallopian Tube Diseases Fallopian Tube Diseases Female Humans Infertility, Female Infertility, Female Ovary Ovary Polycystic Ovary Syndrome Polycystic Ovary Syndrome Polycystic Ovary Syndrome Pregnancy Pregnancy Rate

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