| Is there still a role for reconstructive microsurgery in tubal infertility? | |
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MedLine Citation:
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PMID: 21372711 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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PURPOSE OF REVIEW: To review the current role of tubal reconstructive surgery in the era of assisted reproductive techniques (ARTs). RECENT FINDINGS: After tubal reconstructive surgery, couples may have unlimited attempts to conceive naturally. Operative risks are low; the risk for ectopic pregnancy after surgery is 4-10%. ART is associated with a number of potential complications: severe ovarian hyperstimulation syndrome (0.25-2%), multiple pregnancies (up to 25%), a higher rate of major malformations and stillbirths, and ectopic pregnancy (1-13%). Birth rates following ART differ between 19 and 35%, depending on different laws governing the fertilization of a limited number of oocytes and the number of embryos transferred. Resterilization is a main indication for microsurgery with resulting pregnancy rates up to 84%. Salpingostomy and dense adhesiolysis have the lowest success rates (term pregnancy rates: 3-65%). Proximal tubal obstructions can be successfully treated by tubocornual anastomosis. Hydrosalpinges should be removed prior to in-vitro fertilization if they cannot be reconstructed. ART is recommended for patients older than 37-38 years, for women with severe tubal pathology, after repeated ectopic pregnancies, and in case of male infertility. SUMMARY: Tubal reconstructive surgery still plays a role in infertility treatment. ART has not replaced microsurgery routinely as first-line treatment for tubal infertility. |
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Authors:
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Cordula Schippert; Guillermo-José Garcia-Rocha |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-3-2 |
Journal Detail:
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Title: Current opinion in obstetrics & gynecology Volume: - ISSN: 1473-656X ISO Abbreviation: - Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-3-4 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9007264 Medline TA: Curr Opin Obstet Gynecol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Division of Reproductive Medicine, Department of Gynecology and Obstetrics, Medical School of Hannover, Hannover, Germany. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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