Microsurgical tubocornual anastomosis for occlusive cornual disease: Reproducible results without the need for tubouterine implantation

Citationsfrom the Literature rionic gonadotropin was administered to induce ovulaton. The animals were put to death 1, 4, 8, or 14 days later. The number of corpora lutea and fertilized ova was not affected through day 4. However, on days 8 and 14, a significant reduction in the number of normal fetuses was observed. In a second experiment peritoneal fluid from animals with endometriosis was transferred to normal rabbits 1 day before artificial insemination. A significant reduction in the number of normal fetuses was observed. These studies suggest that failure of nidation due to the maternal environment may be a major factor in infertility associated with endometriosis. tobocornuai anastomosis for occlusive cornuai discwe: Reproducible results without the need for tubouterine implantation

Mkrasurgicai

McComb P Department of Obstetrics and Gynecology, Univerisity of British Columbia, Vancouver, BC, Canada FERTIL. STERIL.; 46/4 (571-577) 1986 Microsurgical tubocornual anastomosis (TCA) and tubouterine implantation are the two primary operations used to treat proximal tubal occlusion (PTO). Tubouterine implantation usually has been reserved for cases of PTO in which the occlusion spans the entire intramural tubal segment. Yet TCA has proven to be more likely to lead to successful pregnancy than tubouterine implantation. In this series, all PTO was treated by TCA. The article compares the reproducibility of results of TCA by two different operators and establishes the usefulness of TCA in all cases of PTO without resort to tubouterine implantation. Fifteen of 26 women achieved viable intrauterine pregnancies, a rate virtually identical to that published earlier by Gomel. Microsurgical TCA can be used to the exclusion of tubouterine implantation to achieve higher pregnancy rates, despite complete intramural occlusion. An alternative to in vitro fertilization embryo transfer: The succemful transfer of human oocytes and spermatozoa to the distal oviduct Nemiro JS; McGaughey RW The Arizona Center for Fertility Studies, Good Samaritan Medical Center, Phoenix, AR, USA FERTIL. STERIL.; 46/4 (644-652) 1986 In vitro fertilization-embryo transfer (IVF-ET) for treatment of irreparable tubal damage provides a means for otherwise hopelessly infertile couples to obtain offspring. Recently a simpler and less expensive procedure was applied as an alternative to IVF-ET to patients with at least one patent fallopian tube. This procedure employs stimulated ovarian cycles, washed and cultured sperm, and laparoscopic aspiration of oocytes. Recovered oocpes and sperm are deposited in the ampulla of the oviduct by means of a catheter. From February 1 to September 28, 1985, 137 cycles yielded 60 laparoscopies (51 patients). Elevated human chorionic gonadotropin observed in 18 cases was confirmed in 12 cases by ultrasound. Nine uterine pregnancies continued with no tubal pregnancy. Success is comparable for this new

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procedure and IVF-ET. The results suggest that many IVFET patients should be offered the simpler and less expensive option of tubal transfer (IT).

Comparison of ultrasonogmpbic topic guided oocytes retrieval

transurethral

and Iaparos-

Fateh M; Ben-Rafael Z; Blasco L; et al Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA FERTIL. STERIL.; 4614 (653-656) 1986 Fifty-eight patients who underwent in vitro fertilization (IVF) treatment were divided into two groups. In 28 patients, ultrasonically guided transurethral follicular aspiration was performed under light general anesthesia. In 30 patients, laparoscopic follicular aspiration was performed under general anesthesia. The mean age for both groups was similar. Follicular recruitment was achieved with human menopausal gonadotropin (hMG) or a combination of clomiphene citrate and hMG. In the ultrasonically guided aspiration group, 128 follicles were aspirated, with a 64qo recovery rate (83 oocytes) and an 88.1% embryo transfer (ET) rate (67 embryos). Three (10.7%) intrauterine pregnancies were established in this group. In the laparoscopic group, 153 follicles were aspirated, with a 68.6% recovery rate (105 oocytes) and an 86.3% ET rate (82 embryos), with 4 (13.3%) intrauterine pregnancies established. Three patients had both procedures done; however, none conceived. There were no statistically significant differences between the two groups. Ultrasonically guided transurethral follicular aspiration should be considered as an alternative route for oocyte retrieval, especially when laparoscopy is contraindicated or when the ovaries are not accessible.

Sexual functioning and psychologic fertilization couples

evaluation

of in vitro

Fagan PJ; Schmidt CW Jr; Rock JA; et al Sexual Behaviors Consultation Unit, Department of Psychiatry, The Johns Hopkins Medical Institutions, Baltimore, MD 21205, USA FERTIL. STERIL.; 46/4 (668-672) 1986 Couples requesting in vitro fertilization (IVF) may be sexually dysfunctional either as an etiologic factor in their infertility or because they experience decreased sexual satisfaction as a reaction to previous infertility treatment. The present study assessed the sexual functioning and psychologic status of 45 married couples who had requested IVF. The couples were given complete psychosexual evaluation by senior staff members of the Sexual Behaviors Consultation Unit and each participant completed the Derogatis Sexual Functioning Inventory (DSFI). Seven couples (15.5%) were experiencing a sexual dysfunction and 13 individuals (14.4%) were given Diagnostic and Statistical Manual of Mental Disorders Ill diagnoses. In total, 19 individuals (21%) of the sample were found to have either a sexual dysfunction or

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