Laparoscopic Fertility-Promoting Procedures of the fallopian tube and the uterus.

Assisted reproductive technology and reproductive surgery can be complementary, and the feasibility of laparoscopic suturing has facilitated conducting reproductive surgery entirely by laparoscopy. Young women with tubal disease can be offered surgery, whereas older women, with their rapid decline in fertility, are better treated with in vitro fertilization (IVF). IVF should be the first line of treatment for women with a severe degree of hydrosalpinx, or with extensive and dense adhesions. However, the presence of hydrosalpinx decreases IVF pregnancy rates. In those whose hydrosalpinx is seen on ultrasound, especially after failed IVF cycles, a laparoscopic salpingectomy can be done. For tubal anastomosis, the superior results of this procedure are well established. The association between uterine myoma and infertility is unclear. However, in those with a distorted uterine cavity, and no other cause of infertility, myomectomy can be considered; myomectomy can be done by laparoscopy. Because of the risks of uterine rupture, proper closure of the uterine incision is of utmost importance.