Preoperative Assessment for Tubal Surgery and in vitro Fertilization

Autor: Alexander Lopata, Ian Johnston, Ian J. Hoult, Andrew L. Speirs
Rok vydání: 1981
Předmět:
Zdroj: The Australian and New Zealand Journal of Obstetrics and Gynaecology. 21:153-155
ISSN: 1479-828X
0004-8666
DOI: 10.1111/j.1479-828x.1981.tb00907.x
Popis: Preoperative assessment techniques are necessary prior to taking corrective measures to remedy infertility. With the advent of in vitro fertilization techniques, reconstructive tubal surgery does not have to be performed as a matter of course anymore; there is now an alternative. The potential success of each procedure for each individual couple should be weighed prior to acting. The results with primary surgical repair of tubes damaged by inflammatory disease or previous surgery are still much greater than a chance of pregnancy as a result of ovum transfer. A complete gynecologic history is the 1st requirement for preprocedural assessment. It even serves a more useful purpose than clinical examination. The only 2 worthwhile tests of tubal patency and function are a well performed hysterosalpingogram and laparoscopy in association with dye instillation. The only radiographic finding which can cause confusion is the so-called "cornual block." It is difficult to decide whether this is organic or functional. The criteria for entry into an in vitro fertilization program are: 1) irreversible damage to the tubes, resulting either from inflammatory disease, surgery, or both; 2) previous unsuccessful treatment for endometriosis; 3) unexplained infertility; 4) immunological problems; or 5) couples with a husband having a poor seminal profile. Careful counseling is necessary.
Databáze: OpenAIRE
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