The limited clinical usefulness of taking a history in the evaluation of women with tubal factor infertility

Hubacher, David; Grimes, David A.; Lara-Ricalde, Roger; Jara, Julio de la; A, García-Luna

doi:10.1016/j.fertnstert.2003.03.002

Cited by 30 publications

(25 citation statements)

References 13 publications

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“…The positive predictive value of history taking, based on symptoms suggestive for previous pelvic inflammatory disease (PID), a history of abnormal vaginal discharge and a previous diagnosis of a lower genital tract infection was only 56, 59 and 35%, respectively, in predicting tuboperitoneal infertility (Hubacher et al, 2004). With respect to pelvic endometriosis, the predictive value of each symptom or even a combination of symptoms in predicting its presence, remains uncertain.…”

Section: Medical History and Tuboperitoneal Infertilitymentioning

confidence: 99%

The position of diagnostic laparoscopy in current fertility practice

Bosteels¹,

Herendael

Weyers

et al. 2007

Human Reproduction Update

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In everyday clinical practice, it is not always clear if and when exactly in the fertility work-up a diagnostic laparoscopy should be offered. The aim of this review is to analyse the available evidence with respect to alternative diagnostic methods for detecting tuboperitoneal infertility and with respect to the position of diagnostic laparoscopy in women with infertility. A literature search of the National Library of Medicine and the National Institutes of Health (PubMed) was performed using the key words 'diagnostic laparoscopy and infertility'. The study methodology was carefully considered in an effort to present conclusions preferably based on randomized controlled trials (RCTs). The routine use of diagnostic laparoscopy for the evaluation of all cases of female infertility is currently under debate. According to data published in retrospective non-controlled studies, diagnostic laparoscopy after several failed cycles of ovulation induction enables the detection of a significant proportion of pelvic pathology amenable to treatment. A Cochrane review has shown that laparoscopic ovarian diathermy in clomiphene-resistant polycystic ovarian syndrome is at least as effective as gonadotrophin treatment, and results in a lower multiple pregnancy rate. The role of laparoscopy before the start of treatment with intrauterine insemination is controversial, according to one RCT. In women with bilateral ultrasonically visible hydrosalpinges, two RCTs have demonstrated increased implantation and pregnancy rates in IVF cycles after salpingectomy. Although RCTs which have studied the benefit of laparoscopic surgery in moderate or severe endometriosis are still lacking, its value has generally been accepted. In conclusion, some specific clinical settings, solid evidence is available to recommend the use of diagnostic laparoscopy in current fertility practice. There is however a need for more RCTs to answer remaining questions regarding its value in the diagnosis and treatment of some patients with infertility.

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Section: Medical History and Tuboperitoneal Infertilitymentioning

confidence: 99%

The position of diagnostic laparoscopy in current fertility practice

Bosteels¹,

Herendael

Weyers

et al. 2007

Human Reproduction Update

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“…We did not include a history of PID. Because it is known that up to 80% of infections especially with C. trachomatis are asymptomatic this should not have a main influence on our results [17,35,36] . For primiparous women, it remains unclear whether there is perhaps a unilateral tubal pathology because these women were not examined using HSG.…”

Section: Discussionmentioning

confidence: 91%

“…It is believed that about 10-30% of women with one event of PID develop tubal occlusion [20] . Because most PID, specially C. trachomatis infections, are asymptomatic, the history of PID or the documentation of clinical symptoms provides limited information on the PID risk in IUD users [21,22] . Therefore, we collected data of women with previous hysterosalpingography (HSG) in the present case-control study with the aim to shed more light on the possible effect of IUDs on tubal pathology.…”

Section: Introductionmentioning

confidence: 99%

Tubal Pathology: The Role of Hormonal Contraception, Intrauterine Device Use and <i>Chlamydia trachomatis</i> Infection

Merki‐Feld¹,

Gosewinkel²,

Imthurn³

et al. 2006

Gynecol Obstet Invest

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Background: The aim of the present study was to identify a possible association between tubal pathology and the contraceptive methods previously used, especially third generation copper intrauterine devices (IUDs). Method: In this retrospective unmatched case-control study, use of contraceptive methods and Chlamydiatrachomatis antibody titres were compared in women with tubal occlusion (n = 84) and infertile women with tubal patency (n = 253) demonstrated by hysterosalpingography. Contraceptive methods were also compared to primiparous women with natural pregnancy. Results: A significantly higher percentage of women with tubal occlusion had previously used an IUD. Positive C. trachomatis antibody testing was found significantly more often in women with tubal occlusion. Neither hormonal contraceptives nor condoms were associated with an increased risk for uni- or bilateral tubal occlusion. Conclusion: In the present study, we observed an increased rate of tubal occlusions in previous IUD users. This should be considered in the contraceptive counseling of young and nulliparous women.

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“…Pour soupçonner une infertilité tubaire, la valeur prédictive positive de l'anamnèse, basée sur des symptômes évoquant une salpingite, des leucorrhées ou des antécédents d'infection génitale basse est relativement faible, estimée à 56, 59 et 35 %, respectivement [3]. De ce fait, elle ne peut constituer un test diagnostique fiable dans l'identification des anomalies tubopéritonéales.…”

Section: Interrogatoireunclassified