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Query: UMLS:C0021359 (infertility)
 26,075 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Laparoscopy was done about three months after hysterosalpingography (HSG) in 121 patients complaining of infertility. Normal patency was found with both technics in 71 patients (58.6%). In 23 of the 97 patients with a normal HSG, however, peritubal or tubal disease was observed at the time of laparoscopy (false-negative results, 19%). Twenty-four tubal obstructions (19.8%) were detected by HSG (16 distal and eight proximal) but five distal and four proximal obstructions were not confirmed by laparoscopy (false-positive results, 7.4%). In addition, laparoscopic evaluation demonstrated endometriosis in 31 cases, polycystic ovaries in six, and uterine fibroids in five.
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PMID:Tubal patency: hysterosalpingography compared with laparoscopy. 15 79

Diagnostic laparoscopy is of most value in the evaluation of infertility and for completing the gynaecological investigation of obscure cases of chronic pelvic pain. Its use to exclude ectopic pregnancy, salpingitis and pelvic cancer is more controversial. The management of some cases of primary amenorrhoea is aided by laparoscopic gonadal biopsy. The excessive demand for female sterilization will ensure that the laparoscope continues to be used for this purpose and is leading to a compromise. The surgical techniques which have been proved to be most effective are being replaced by methods favoured for their potential reversibility and rapid patient turn-over. If all our laparoscopes were abandoned, gynaecological surgery would perhaps not suffer a major setback, but, for the present, those who neglect laparoscopy are losing an important dimension of modern practice.
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PMID:The use of laparoscopy in gynaecology. 15 14

The hysterosalpingograms of 98 patients with infertility were reviewed with reference to technical problems, radiological features of each pathology and accuracy of reporting. Findings were confirmed by review of the reports of laparotomy or laparoscopy on all patients. Of the total number of fallopian tubes investigated (196), 70 hydrosalpinges were correctly diagnosed from a total of 77. Agreement between HSG and operation was achieved in 123 of 127 fallopian tubes with peritubal adhesions, in all six of those with cornual spasm and in eight with cornual occlusion. In 16 of 20 fallopian tubes with partial distal occlusion, reporting was correct. With the potential accuracy of HSG diagnosis, we contend that it should be a preliminary procedure in every case, and in many may be the only investigation of tubal patency required prior to surgery or conservative management.
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PMID:A radiological approach to infertility--hysterosalpingography. 15 47

We report a simple and direct procedure for the measurement of circulating free testosterone concentrations by using saliva as a matrix rather than serum. There is a close correlation between saliva testosterone values measured by radioimmunoassay, calculated values of free testosterone, and free testosterone estimated by equilibrium dialysis. Our method is direct and has the advantage that the biologic fluid can be obtained routinely by noninvasive techniques outside the clinic during a course of therapy. We also show that a single saliva value is of greater diagnostic use than any of the currently used androgen assays. Testosterone was found to be elevated in the saliva of 17 infertility patients diagnosed as having polycystic ovarian syndrome, 14 of these patients were hirsute.
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PMID:Saliva as a matrix for measuring free androgens: comparison with serum androgens in polycystic ovarian disease. 15 32

Twenty-eight patients presenting with initial complaints of infertility or chronic pelvic pain were found to have pelvic endometriosis at laparoscopy. Destruction of the endometriotic lesions by means of electrocoagulation was performed via laparoscopy in a group of 19 patients. The remaining nine patients did not undergo such management. In the treatment group, seven of the 11 patients with chronic pain experienced complete relief of their symptoms, and six of the eight patients with infertility became pregnant postoperatively. Patients in the control group had a less favorable outcome. Only one of five patients with chronic pain had relief and one of four patients with infertility became pregnant following laparoscopy without cauterization. Electrocoagulation of pelvic endometriotic lesions under laparoscopic control appears to be satisfactory for the management of selected patients with chronic pelvic pain or infertility.
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PMID:Electrocoagulation of pelvic endometriotic lesions with laparoscopic control. 15 98

Microsurgery is a techniqe whereby visual acuity is increased through the use of a microscope or other optical magnifying device. Because of the delicate nature of this procedure, an experienced surgeon does not necessarily make a good microsurgeon. A good microsurgeon should be able to consistently reanastomose 1 to 2 mm vessels. The technique is learned through constant practice on laboratory animals. A special attitude and demeanor toward microsurgical techniques is also important for success. Microsurgery of the fallopian tube should be done only under special conditions, and using special microsurgical instruments and equipments. Before tubal plastic surgery is considered, 2 issues must first be resolved: 1) if there is any other cause for the infertility, and 2) if tubal plastic surgery is indicated for the patient at this time. Before tubal surgery is performed, the following conditions must be met: 1) semen analysis must be met, or couple must agree to artificial insemination using a donor; 2) female should have either spontaneous or induced ovulatory cycle; and 3) couple must understand possibility of failure, overall success rate, and sequelae of ectopic pregnancy. Couple must also agree to preoperative investigation of the tube. General tubal techniques include hysterosalpingography, laparoscopy, and hydrotubation. Also discussed are implantation, fimbriolysis, fimbrioplasty, and salpingostomy.
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PMID:Microsurgery of the fallopian tube. 15 81

The advent in recent years of safe endocoagulation (thermocoagulation within the abdomen) has permitted operative laparoscopic treatment of the tubal factor in infertility in selected cases. This paper reviews the results of operative laparoscopy in 223 cases treated for infertility between 1971 and 1976. Tubal occlusion was present in 133 patients before surgical intervention. Following operative laparoscopy, tubal patency was demonstrated in 67% on testing at the time of operation and in 12% at the first postoperative hydrotubation. In only 21% of cases was tubal patency not achieved by these methods. Those cases requiring isthmic salpingostomy, ampullary or isthmic-tubal implantation, or end-to-end anastomosis were further treated by laparotomy and microsurgery. Ninety cases of pelvic endometriosis were treated by a combination treatment of thermocoagulation, ovarian cyst resection, and the antigonadotropin agent, danazol. Ovariolysis, salpingolysis, fimbrioplasty, and salpingostomy can easily be performed using operative laparoscopy as the method of choice with a minimum of complications, shortened hospitalization time (2 days), and the potential for a repeat procedure or a follow-up laparotomy should this be necessary. The pregnancy rate following laparoscopic treatment for the correction of distal tubal occlusion was 30.5% and for endometriosis genitalis externa, 40%. These rates compare favorably with the rates following procedures involving laparotomy and microsurgery for correction of similar lesions.
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PMID:Treatment of female infertility due to tubal obstruction by operative laparoscopy. 15 49

The conventional approach to laparoscopy in an infertility workup has been to perform the procedure in the latter stages. Alternative ways have been suggested. Our investigation attempted to assess the suitabilities of an alternative approach. The laparoscopic findings in a group of 231 patients examined as part of an infertility workup have been analyzed. The predictability of abnormal findings has been demonstrated with accuracy in those patients with certain symptomatic or historical associations. The ability to predict abnormalities would suggest that laparoscopy should be performed early in the workup in this group. This holds true regardless of the discovery of any other abnormality which might be thought to be related to the patient's infertility.
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PMID:Historical predictability of abnormal laparoscopic findings in the infertile woman. 16 Apr 51

The article presents a review of the evolution of indications for laparosocpy during the years 1973-1977. Laparoscopy is always indicated in case of chronic pelvic pains, ovarian malignant tumors, tubal infertility, adnexitis or ectopic pregnancy. In such cases the accurate inspection of the pelvic cavity can allow precise diagnosis and therapy. Laparoscopy can also be repeated to control the effectiveness of therapy, especially in the surveillance of ovarian cancers. On the other hand, laparoscopy should not be systematically performed in cases of isolated pelvic pains, in case of ovarian cyst or fibroma, or in case of amenorrhea, where clinical examinations and biological explorations are sufficient to determine diagnosis and therapy. Laparoscopy should be used only when there are contraindications among biological findings, or in cases of therapeutic failures.
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PMID:[The evolution of the indications for laparoscopy between 1973 and 1977. 1,758 cases (author's transl)]. 16 66

The authors describe the methods employed by the Artificial Insemination Section of the Division of Veterinary Services in collaboration with the Reproduction and Bacteriology Section of the Veterinary Research Institute, Onderstepoort when herds are examined for infertility. A "herd" rather than an "individual animal" approach is advocated and certain infectious causes of infertility are discussed.
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PMID:The "herd approach" to bovine reproductive disorders. Part I: The diagnosis and management of infectious infertility. 17 80


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