Role of reproductive surgery in the era of assisted reproductive technology

• Published in: Best practice & research. Clinical obstetrics & gynaecology Vol. 26; no. 6; pp. 747 - 755
• Main Authors: Tulandi, Togas, MD, MHCM, Akkour, Khalid, MD
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.12.2012
• Subjects: assisted reproductive technology; endometrial polyp; endometriosis; Endometriosis - complications; Endometriosis - diagnosis; Endometriosis - surgery; Female; Fertility Preservation; Fertilization in Vitro; Humans; hysteroscopy; Hysteroscopy - methods; in-vitro fertilization; infertility; infertility surgery; Infertility, Female - etiology; Infertility, Female - surgery; laparoscopy; Laparoscopy - methods; Leiomyoma - complications; Leiomyoma - diagnosis; Leiomyoma - surgery; myoma; Obstetrics and Gynecology; Polyps - complications; Polyps - diagnosis; Polyps - surgery; Pregnancy; reproductive surgery; Reproductive Techniques, Assisted; Uterine Neoplasms - complications; Uterine Neoplasms - diagnosis; Uterine Neoplasms - surgery; laparoscopy; assisted reproductive technology; reproductive surgery; in-vitro fertilization; hysteroscopy; infertility surgery; endometriosis; endometrial polyp; fertility preservation; infertility; myoma
• ISSN: 1521-6934; 1532-1932
• DOI: 10.1016/j.bpobgyn.2012.04.003

Reproductive surgery could be divided into surgery as a primary treatment for infertility, surgery to enhance in-vitro fertilisation outcome, and surgery for fertility preservation. A shift has occurred away from surgery as a primary treatment of infertility to surgery playing a crucial part in enhancing in-vitro fertilisation outcome and for fertility preservation. A normal uterine cavity is a prerequisite for implantation, and hysteroscopic correction of intrauterine pathology, including polypectomy, myomectomy and metroplasty, increases the chances of having a successful pregnancy. Management of hydrosalpinx before in-vitro fertilisation treatment by laparoscopic salpingectomy or proximal tubal occlusion increases the in-vitro fertilisation delivery rate. Finally, surgery plays an important role in preservation of fertility. This includes laparoscopic ovarian transposition, ovarian tissue removal for cryopreservation and ovarian transplantation.