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Gynecol Obstet Fertil. 2014 Feb;42(2):97-103. doi: 10.1016/j.gyobfe.2013.12.005. Epub 2014 Jan 21.

[Transvaginal hydrolaparoscopy for infertility investigation: a retrospective study, about 262 patients].

[Article in French]

Author information

  • 1Service de chirurgie gynécologique, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France. Electronic address: aurelie_abergel@hotmail.com.
  • 2Service de chirurgie gynécologique, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France.
  • 3Service de biologie, médecine de la reproduction et gynécologie endocrinienne, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France.

Abstract

OBJECTIVES:

To evaluate fertiloscopy's results and to redefine its place in the management of female infertility.

PATIENTS AND METHODS:

Retrospective study including 262 cases of fertiloscopy and 260 patients with primary or secondary idiopathic infertility. Analysis of infertility assessment's findings (hysterosalpingography), perioperative data (operating technique, laparoscopic conversion, failures and complications). Comparison of hysterosalpingography's findings and peroperative data; comparison of fertiloscopy and laparoscopy's findings.

RESULTS:

Access to peritoneal cavity was possible for 248 fertiloscopies (95%), and pelvic exploration was considered as complete for 226 cases (86%). Laparoscopic conversion was necessary in 54 cases (21%) and indicated by surgical pathology in more of one third of the cases (n=20). Our failure rate was only 5,3% (n=14), partially thanks to posterior colpotomie (70% of failures avoided). We deplored 8 complications (3.05%) which were not severe (no bowel injury), among which half were linked with the hysteroscopy (uterus perforation). In the cases of laparoscopic conversion, laparoscopic findings confirmed per-fertiloscopic data, considering adhesions and tubal patency. Hysterosalpingography had poor sensibility and positive predictive value.

DISCUSSION AND CONCLUSION:

Fertiloscopy is a safe, reproducible and not much invasive procedure. It can be substituted to laparoscopy in infertility assessment when there is no obvious surgical indication. Moreover, it could be considered as a first line way of investigation in female infertility management, instead of hysterosalpingography which has poor sensibility and positive predictive value.

Copyright © 2013 Elsevier Masson SAS. All rights reserved.

KEYWORDS:

Drilling ovarien; Fertiloscopie; Fertiloscopy; Hydropelviscopie transvaginale; Hysterosalpingography; Hystérosalpingographie; Infertility; Infertilité; Ovarian drilling; Plastie tubaire; Transvaginal hydrolaparoscopy; Tubal patency

PMID:
24461467
[PubMed - indexed for MEDLINE]
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