Should diagnostic/surgical laparoscopy be performed on infertile patients with normal hysterosalpingography?

M. Fatum

Department of Obstetrics and Gynaecology, Hebrew University, Hadassah Ein-Kerem Medical Centre, Kiryat Hadassah, P.O.Box 12000, Jerusalem 91120, Israel

Correspondence: E-mail: fatum{at}md.huji.ac.il


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 Introduction
 
Dear Sir,

We read with great interest the comments of Dr Marik on our last debate article. However, we disagree with him in regard to the `significant impact of diagnostic/operative laparoscopy on patient's general health' in normal infertile women. We do not think that such asymptomatic/pain-free women whose only complaint is infertility should undergo a diagnostic laparoscopy for the mere sake of identifying endometriotic lesions or other medical conditions. These patients do not deserve such an invasive procedure and should be treated according to the recommended guidelines.

As we summarized, we do not believe that laparoscopic control of endometriosis and peritubal adhesions is the best and the shortest treatment to offer to these infertile patients. However, in some circumstances, i.e. when ART programmes are not available or not desired, laparoscopy may offer some, though small, benefit to these patients. Patients should be aware of the low yield of such an approach.





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