The role of surgery in infertility

The Subfertility Handbook Buy print or eBook [Opens in a new window] A Clinician's Guide - Frontmatter - Contents - List of contributors - 1 Introduction - 2 The first interview with an infertile couple - 3 Assessment of the female partner - 4 Assessment of the male partner - 5 Treatment options for male subfertility - 6 Management of the woman with chronic anovulation - 7 Cervical factor, unexplained subfertility and artificial insemination with husband sperm - 8 In-vitro fertilization: indications, stimulation and clinical techniques - 9 The role of gamete intrafallopian transfer - 10 The use of assisted reproductive technology for the treatment of male infertility - 11 The use of donor insemination - 12 The donor egg programme - 13 Endometriosis - 14 The role of ultrasound in subfertility - 15 The role of surgery in infertility - 16 Laboratory techniques - 17 The results of assisted reproductive technology - 18 Infertility counselling - Index Published online by Cambridge University Press: 06 July 2010 By Edited by Book contents - Frontmatter - Contents - List of contributors - 1 Introduction - 2 The first interview with an infertile couple - 3 Assessment of the female partner - 4 Assessment of the male partner - 5 Treatment options for male subfertility - 6 Management of the woman with chronic anovulation - 7 Cervical factor, unexplained subfertility and artificial insemination with husband sperm - 8 In-vitro fertilization: indications, stimulation and clinical techniques - 9 The role of gamete intrafallopian transfer - 10 The use of assisted reproductive technology for the treatment of male infertility - 11 The use of donor insemination - 12 The donor egg programme - 13 Endometriosis - 14 The role of ultrasound in subfertility - 15 The role of surgery in infertility - 16 Laboratory techniques - 17 The results of assisted reproductive technology - 18 Infertility counselling - Index Introduction In 270 infertility patients seen between 1990 and 1991 in a private gynaecological practice, two-thirds had pelvic disease requiring surgery (personal series). Sixty percent of the patients became pregnant subsequent to surgery for pelvic adhesions, endometriosis, tubal blockage, fibroids, adenomyosis, and uterine intracavity polyps, fibroids or adhesions. In contrast, only 12% of male infertility can be treated by surgery (Hudson, Baker and de Kretser, 1980). Infertility surgery rarely requires laparotomy, most procedures being performed by laparoscopy, hysteroscopy and, more recently, falloposcopy. The last three techniques are used both to diagnose and treat the cause of infertility. Diagnostic laparoscopy is being simplified by the development of finer laparoscopes, the new 2-mm-diameter micro laparoscope requiring much smaller incisions and less anaesthesia and allowing quicker patient recovery (Downing and Wood, 1995). Tubal surgery A variety of procedures may be performed to overcome tubal infertility. These include fimbrioplasty, salpingostomy, salpingo-ovariolysis, tubotubal anastomosis, uterotubal anastomosis, and tubal cannulation. The principles of tubal surgery include the following. Reduction of tissue trauma by atraumatic techniques using fine instruments and keeping tissue surfaces moist. Complete haemostasis reduces the risk of adhesions. Abnormal tissue such as thick adhesions should be excised. Tissue planes must be realigned in the normal anatomical position. Magnification enables the surgeon to define the anatomy and pathology more precisely and facilitates the application of the above principles. It also enables the surgeon to use fine instruments and fine sutures. - Type - Chapter - Information - The Subfertility HandbookA Clinician's Guide, pp. 187 - 219Publisher: Cambridge University PressPrint publication year: 1997 Accessibility compliance for the PDF of this chapter is currently unknown and may be updated in the future. To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle. Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply. Find out more about the Kindle Personal Document Service. - The role of surgery in infertility - - Book: The Subfertility Handbook - Online publication: 06 July 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. - The role of surgery in infertility - - Book: The Subfertility Handbook - Online publication: 06 July 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. - The role of surgery in infertility - - Book: The Subfertility Handbook - Online publication: 06 July 2010