Select and treat at laparoscopy and dye test improves the spontaneous pregnancy

Abstract

Infertility affects 1 in 7 couples in the UK. Tubal patency tests are an important part of infertility investigations. We conducted this observational study to determine the interval between a laparoscopy and dye test and spontaneous conception in women with unexplained infertility and minimal to mild endometriosis and pelvic adhesions treated during the procedure. The clinical records of 432 women coded as having had a laparoscopy and dye test or laparoscopy and tubal patency test between April 2007 and March 2010 were retrieved from a computerised theatre database. Pregnancies were identified through a computerised maternity booking system. Spontaneous pregnancies were recorded in 162 women following surgery (37.5%). There was a significant difference in conception rates between women with unexplained infertility and those with minor abnormalities treated at the time of diagnosis (43% vs. 58%, p = 0.019). Eighty percent of women who conceived spontaneously achieved their pregnancy within 18 months of surgery. A high proportion of women with unexplained infertility or minor abnormalities treated at the time of a laparoscopy and dye test conceived spontaneously within 12 months.

Evaluation of cases of spontaneous conceptions during COVID-19 outbreak and lock down: multicentric retrospective analytic study

“…18 Both medical and surgical treatment of pelvic pathology arrests the progression of disease. 19 In our study 9 of 84 (PR 10%) ladies with previous history of fertility enhancing pelvic surgery conceived during the COVID crisis spontaneously.…”

MRI versus laparoscopy to diagnose the main causes of chronic pelvic pain in women: a test-accuracy study and economic evaluation

“…Some clinicians prefer that a diagnostic and therapeutic investigation is performed as part of a single proceduresometimes referred to as 'see-and-treat' laparoscopy. 49,50 For example, adhesiolysis may be performed in what started as a diagnostic procedure. 51 Depending on the severity and corresponding patient consent, endometriosis may be treated at the time of diagnosis by either electrocoagulation, laser vaporisation or excision.…”

Female infertility

“…The gold standard for diagnosis of endometriosis is laparoscopy; however, ultrasound can often pick up endometriomas. The treatment of mild-to-moderate endometriosis improves the chances of natural conception (Younas, Majoko, Sheard, Edwards, & Bunkheila, 2014). In the patient trying to conceive, excision of endometriosis deposits is associated with better fertility outcomes, less pain and less re-occurrence, however, excision of endometriomas is debatable as it may affect ovarian reserve (Healey, Ang, & Cheng, 2010).…”