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Human Reproduction, Vol. 14, No. suppl_1, pp. 120-136, 1999
© 1999 European Society of Human Reproduction and Embryology

Tubal surgery in the era of assisted reproductive technology: clinical options

C. Posaci1,2, M. Camus1, K. Osmanagaoglu1 and P. Devroey1,3

1 Centre for Reproductive Medicine, Dutch-speaking Brussels Free University Laarbeeklaan 101, B-1090 Brussels, Belgium 2 Dokuz Eylul Universitesi Tip Fakultesi, Kadin Hastaliklari ve Dogum Anabilim Dali Inciralti 35350 Izmir, Turkey

Correspondence: 3To whom correspondence should be addressed

We reviewed the place of tubal surgery in the era of assisted reproductive technology. Reversal of tubal ligation is one of the main indications for tubal microsurgery. Adhesiolysis has the best results if the adhesion is the only factor responsible for infertility. There are no differences between adhesiolysis by laparoscopy or by laparotomy, and so laparoscopy must be preferred. Proximal tubal obstructions can be successfully treated by microsurgical tubocornual anastomosis. As far as distal tubal lesions are concerned, success rates depend strictly on the pre-existing tubal disease in distal tubal lesions and tubal surgery frequently fails; in-vitro fertilization (IVF) must therefore be considered in such circumstances. In conclusion, we think that IVF and tubal surgery must be considered to be complementary rather than competitive procedures. Adequate selection of patients is crucial to find the best therapeutic approach.

Key words: female/laparoscopic surgery/microsurgery/surgical therapy/tubal infertility


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