CONCURRENT TUBOPLASTY AND ASSISTED REPRODUCTION

Objective: To review and summarize the role of combining assisted repr oductive technologies (ART) with lysis of adhesions and microsurgical tuboplasty in selected groups of patients. Design: A retrospective ana lysis of the available literature and a review of the results of concu rrent fimbriectomy reversal and ART. Conclusion: In a relatively few a nd highly selected patients, the concurrent use of ART and laparotomy or laparoscopy for lysis of adhesions and tuboplasty can more safely a ccess the ovaries for oocyte retrieval and address associated problems such as pelvic pain while reducing cost. Examples of such cases inclu de patients with ovaries in abnormal locations, on a congenital basis or after extensive bowel or urogenital reconstructive surgery. Because some procedures such as fimbriectomy reversal have a relatively low f ecundity, there is potential for increasing cumulative pregnancy rates when ART and microsurgery are combined. The advantages of increased f ecundity and cost-effectiveness must be weighed against the disadvanta ges of operating room scheduling and the potential surgical and anesth etic risks.