Surgery: Should lysis of adhesions be performed when in-vitro fertilization and embryo transfer are available?

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Abstract

This study was undertaken to report the results of microsurgical lysis of peri-adnexal adhesions and identify the patients who should be offered surgery and those who should be treated by in-vitro fertilization (IVF). In all, 19 women had filmy adhesions and 32 had dense adhesions; 68.4% of women with filmy adhesions conceived compared with 34.4% of women with dense adhesions (P=0.02). In patients with filmy adhesions, the cumulative pregnancy rate 2 years after operation (47%) is similar to that reported after five cycles of IVF (52%), leading us to conclude that such patients should be offered surgery first. Dense adhesions are best treated by IVF. Lysis of filmy adhesions produces a similar intra-uterine pregnancy rate whether performed by laparotomy (57.9%) or laparoscopy (56.6%). As operative laparoscopy offers the greatest patient comfort, it is the treatment of choice in these patients.

Original languageEnglish
Pages (from-to)2339-2341
Number of pages3
JournalHuman Reproduction
Volume9
Issue number12
DOIs
StatePublished - Dec 1994

Funding

FundersFunder number
Floersheim Foundation
Zurich

    Keywords

    • Adhesions
    • IVF embryo transfer
    • Tuboplasty

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