<i>Pelvic Factor Infertility: Diagnosis and Prognosis of Various Procedures</i>

Bulletti, Carlo; Panzini, Ilaria; Borini, Andrea; Coccia, E.; Levi-Setti, Paolo Emanuele; Palagiano, Antonio

doi:10.1196/annals.1434.020

Cited by 10 publications

(10 citation statements)

References 11 publications

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“…3 The benefits of surgical therapy for endometriosis-related infertility have been well documented. 1,18,19 With the large diffusion of ART, however a growing number of infertile women with a history of endometriosis attempt this treatment. In a previous study, after an integrated laparoscopy-IVF approach, we obtained a pregnancy rate of 56.1%, which is significantly higher than the 37.4% observed after surgery only.…”

Section: Discussionmentioning

confidence: 99%

Does Controlled Ovarian Hyperstimulation in Women with a History of Endometriosis Influence Recurrence Rate?

Coccia

Rizzello

Scarselli

2010

Journal of Women's Health

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Background: Endometriosis is a common estrogen-dependent disease. The aim of this study was to assess whether controlled ovarian hyperstimulation (COH) for assisted reproductive technology (ART) was associated with an increased incidence in endometriosis recurrence as documented by transvaginal ultrasound (TV-US). Methods: In a retrospective cohort study of 592 patients submitted to laparoscopy for endometriosis, 177 with infertility-related endometriosis who underwent a periodic ultrasound follow-up after laparoscopy were selected. Women who started ART after laparoscopy (n ¼ 90) were compared with the control group, who did not undergo ART (n ¼ 87). Recurrence of endometriosis was defined as the presence of endometriotic lesions observed through TV-US.Results: During a long-term TV-US follow-up (1-15 years), 40 (22.6%) recurrences were observed. Patients submitted to ART showed a cumulative recurrence rate similar to that of the control group (28.6% and 37.9% respectively, p ¼ 0.471). Recurrent lesions were ovarian cysts (47.5%), ovarian nodules (37.5%), and rectovaginal disease (15%). The stratified analysis based on stages of endometriosis and pelvic pain did not show differences. Conclusions: Gonadotropin treatments do not seem to affect the natural history of endometriotic lesions. The most important prognostic factors in recurrent disease observed by TV-US seem to be the stage of endometriosis and the presence of pelvic pain at the time of the first laparoscopic treatment.

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Section: Discussionmentioning

confidence: 99%

Does Controlled Ovarian Hyperstimulation in Women with a History of Endometriosis Influence Recurrence Rate?

Coccia

Rizzello

Scarselli

2010

Journal of Women's Health

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“…An early study reported that infertile women have 6 to 8 times the rate of endometriosis compared with fertile women. [3] In our study, endometriosis is the most common positive pathologic findings in laparoscopy (57.7%, 26/45). Meuleman et al [14] reported that infertile women with normal ovulatory cycles and normospermic partners, have endometriosis in nearly 50% cases.…”

Section: Discussionmentioning

confidence: 53%

“…It provides information on endometriosis, tubal patency, and pelvic adhesions and a chance to fix these lesions concurrently. [3] However, advances in non-invasive techniques such as vaginal ultrasound or hysterosalpingography (HSG) have questioned the need for laparoscopy in the infertility workup. The role of laparoscopy, especially in women whose normal screening tests suggest that pelvic pathology seem to be unlikely.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic surgery

Cai

Guan

et al. 2019

Medicine

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Patients who undergo several in-vitro fertilization (IVF) treatment cycles and fail to conceive present a frustrating problem to the clinician. When 1 cycle of IVF treatment fails, should we offer the couples to choose additional cycle of IVF instead of evaluation of the potential peritoneal factor? In cases of otherwise unexplained infertility, the investigation cannot be considered to be complete until laparoscopy has been performed. The aim of the study is to investigate the fertility outcome of laparoscopic treatment in infertile women with repeated IVF failures. This is a retrospective case-control study conducted in a tertiary care, academic teaching hospital from January 2012 to December 2015. Patients recruited in this study were classified into 2 groups. Study group (n = 45) were offered laparoscopy for evaluation of infertility, control group (n = 45) elected to proceed to IVF without laparoscopy. Diagnostic laparoscopy and subsequent excision of suspected endometriotic lesions, lysis of adhesion and treatment of tubal pathology were performed when indicated. Forty-four (97.8%) patients in study had pelvic pathologies and the treatment was performed at the same time. Twenty-four patients in study group conceived including 16 patients conceived spontaneously and 14 patients conceived with additional IVF following laparoscopy management. There was a significant difference in the ongoing pregnancy rates between patients conceived through IVF in study group and control group (41.9% vs 19.6%, P < .05). Laparoscopy in women with normal hysterosalpingography but recurrent IVF failures can detect unrecognized pelvic pathologies. Laparoscopy evaluation prior to additional cycle of IVF seems to improve the subsequent pregnancy rate.

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“…In 17 of the remaining 19 case .In contrary to the reported finding (19) In contrary to the reported finding ; Bulletti CB investigated the exclusion of pelvic factor of infertility through the same tests, namely SHSG, HSG and laparoscopy In their study endometriosis was diagnosed laparoscopically in 344 out of 1080women. Only 44 women (13%) with endometriosis showed bilateral tubal block (20) 68 infertile patients underwent hysterosonosalpingography using saline as contrast medium, and then further assessment by laparoscopy and hysteroscopy were performed to them Sensitivity and specificity of hysterosonosalpingography for the assessment of tubal patency was 100% and66% respectively. Negative predictive value was 100% and positive predictive value was 61%(21)There are study compared the three dimensional SHSG to diagnostic laparoscopy with chromopertubation in the assessment of tubal patency The sensitivity of three dimensional SHSG for detecting tubal patency was 100% with a specificity of 67%.…”

Section: Discussion:-mentioning

confidence: 99%

Sonohysterography Versus Laparoscopic Chromopertubation for the Assessment of Tubal Patency in Infertile Women.

Almashed¹,

Farag²,

Morad³

et al. 2016

IJAR

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Objectives:-.In this study, our goal was to determine the diagnostic value of SHG for the diagnosis of tubal obstruction by comparison of SHG and laparoscopic results. Methods:-This study was based on the assessment of tubal patency by SHG and by the laparoscopy in 50 patients. All patients underwent HSG as a routine infertility workup, SHG was performed then laparoscopy was done subsequently. Results:-patients with HSG findings are21of fallopian tube occluded(42.0%) and 29 patent(58.0%). Fifty patients underwent SHG. In 34 patients (68%), at least 1 fallopian tube was patent, and 6 patients (12%) were reported to have bilateral tubal obstruction. All 50 patient underwent laparoscopic evaluation its finding is 32of fallopian tube are patent(64%) and 18 of fallopian tube are blocked(36%) 7of patient of bilateral block and1of unilateral block Conclusions:-Sonohysterography is not an accurate method for the determination of fallopian tube patency .but It is a simple, safe, and welltolerated technique with a low risk of adverse effects and severe complications .laparoscopy is an accurate method for the assessment of fallopian tube patency.

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Pelvic Factor Infertility: Diagnosis and Prognosis of Various Procedures

Cited by 10 publications

References 11 publications

Does Controlled Ovarian Hyperstimulation in Women with a History of Endometriosis Influence Recurrence Rate?

Does Controlled Ovarian Hyperstimulation in Women with a History of Endometriosis Influence Recurrence Rate?

Laparoscopic surgery

Sonohysterography Versus Laparoscopic Chromopertubation for the Assessment of Tubal Patency in Infertile Women.

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