Surgical treatment of female infertility: value of paradoxical oophorectomy

The outcome of surgical treatment for infertility in 111 women has been reviewed. The procedures used, depending on the lesions present, were: myomectomy; tubal implantation, anastomosis, and salpingostomy; division of adhesions; ovarian wedge resection; and "paradoxical" oophorectomy. The results are analysed by comparing pregnancy rates after surgery with those for the total time of exposure. Only for division of adhesions and oophorectomy were statistically significant results obtained. Many of the pregnancies, however, occurred soon after operations that had been preceded by long periods of infertility. With single tube patency, which had been proved at laparotomy, contralateral oophorectomy appeared to be of value. In the light of these observations we suggest that in cases of tubal ectopic gestation salpingo-oophorectomy should be considered in preference to salpingectomy when the opposite tube and ovary are healthy. Wedge resection for the Stein-Leventhal syndrome effectively restored ovulatory activity.