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Human Reproduction, Vol. 17, No. 7, 1684-1687, July 2002
© 2002 European Society of Human Reproduction and Embryology

Debate continued

Investigation of the infertile couple

A one-stop outpatient endoscopy-based approach

Stephan Gordts1, Rudi Campo1, Patrick Puttemans1, Hugo Verhoeven2, Luca Gianaroli3, Jan Brosens4 and Ivo Brosens1,5

1 Leuven Institute for Fertility and Embryology, Leuven, Belgium, 2 Center for Reproductive Medicine, Düsseldorf, Germany, 3 S.I.S.M.E.R., Bologna, Italy and 4 Department of Reproductive Sciences and Medicine, Imperial College School of Medicine, London, UK

Transvaginal hydrolaparoscopy (THL) is a new culdoscopic technique for exploration of the pelvic cavity that takes advantage of micro-endoscopic technology and uses aquaflotation for inspection of the tubo-ovarian structures. In infertility patients, THL is systematically combined with mini-hysteroscopy, chromopertubation, fimbrioscopy and, when indicated, salpingoscopy. Mini-hysteroscopy in combination with the chromopertubation test allows accurate assessment of the uterine cavity and tubal patency. The transvaginal access combined with the aquaflotation during THL facilitates detailed inspection of the tubo-ovarian structures and detection of subtle pelvic disease. This combined transvaginal endoscopic approach allows complete evaluation of the reproductive tract. THL is better tolerated than hysterosalpingography, less invasive than standard laparoscopy, and can be used safely as a first line investigation of the female partner in a one-stop infertility clinic.

Key words: infertility investigation/mini-hysteroscopy/outpatient procedure/salpingoscopy/transvaginal hydrolaparoscopy

5 To whom correspondence should be addressed at: Leuven Institute for Fertility and Embryology, Tiensevest 168, B-3000 Leuven, Belgium. E-mail: ivo.brosens{at}med.kuleuven.ac.be


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