Endoscopic procedures in ART: an overview

Abstract

In the past two decades, improvement in instrumentation has lead to widespread use of gynaecological endoscopy. Most doctors involved in delivering infertility services have had some training and experience in gynaecological endoscopy. Laparoscopy is a commonly performed endoscopic procedure in the evaluation and management of the infertile couple. The economic and safety issues of diagnostic laparoscopy should be considered. Evidence suggests that laparoscopy has a role to play in evaluating women with unexplained infertility prior to ART. Infertility investigations and treatment are a long process. A one-stop approach has therefore been proposed for couples presenting with infertility. Transvaginal hydrolaparoscopy is systematically combined with mini-hysteroscopy, chrompertubation, fimbrioscopy and salpingoscopy, if needed. The combination of these procedures is referred to as "fertiloscopy". This approach has been shown to be feasible, accurate for determining tubal patency (95%), safer than laparoscopy with respect to bowel injuries, better tolerated and certainly costeffective.

Changing trends in gynaecological surgery—a challenge for training

“…In the fields of both benign gynaecology and gynaecological oncology, there are many examples of the value of endoscopic procedures, both for diagnoses and therapy [1,2]. How do we learn surgery, and how does it influence what we do?…”