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The Role of Laparoscopic Investigation in Enabling Natural Conception and Avoiding in vitro Fertilization Overuse for Infertile Patients of Unidentified Aetiology and Recurrent Implantation Failure Following in vitro Fertilization

The present study aims to explore the effectiveness of laparoscopic surgery on women presenting with infertility, of unidentified aetiology according to the standard infertility investigation, and recurrent failed In Vitro Fertilization (IVF) attempts. Identifying and correcting possible underlying...

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Autores principales: Pantou, Agni, Simopoulou, Mara, Sfakianoudis, Konstantinos, Giannelou, Polina, Rapani, Anna, Maziotis, Evangelos, Grigoriadis, Sokratis, Tsioulou, Petroula, Syrkos, Stephen, Souretis, Kyriakos, Koutsilieris, Michael, Pantos, Konstantinos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6517944/
https://www.ncbi.nlm.nih.gov/pubmed/31013645
http://dx.doi.org/10.3390/jcm8040548
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author Pantou, Agni
Simopoulou, Mara
Sfakianoudis, Konstantinos
Giannelou, Polina
Rapani, Anna
Maziotis, Evangelos
Grigoriadis, Sokratis
Tsioulou, Petroula
Syrkos, Stephen
Souretis, Kyriakos
Koutsilieris, Michael
Pantos, Konstantinos
author_facet Pantou, Agni
Simopoulou, Mara
Sfakianoudis, Konstantinos
Giannelou, Polina
Rapani, Anna
Maziotis, Evangelos
Grigoriadis, Sokratis
Tsioulou, Petroula
Syrkos, Stephen
Souretis, Kyriakos
Koutsilieris, Michael
Pantos, Konstantinos
author_sort Pantou, Agni
collection PubMed
description The present study aims to explore the effectiveness of laparoscopic surgery on women presenting with infertility, of unidentified aetiology according to the standard infertility investigation, and recurrent failed In Vitro Fertilization (IVF) attempts. Identifying and correcting possible underlying pathologies by laparoscopy may subsequently enable natural conception in an effort to address infertility and avoid IVF overuse. One-hundred and seven (107) women with unidentified aetiology of infertility and recurrent failed IVF attempts met the inclusion criteria. Laparoscopic surgery was performed as the endpoint of the patients’ diagnostic journey, aiming to identify a possible underlying factor as the cause of infertility. Sixty-two (62) out of 107 patients (57.94%) that underwent laparoscopy were diagnosed with endometriosis, 25 out of the 107 patients (23.3%) were diagnosed with periadnixal and pelvic adhesions, and 20 cases (18.69%) presented with no pathology and remained unexplained. Following identification and correction of endometriosis and pelvic adhesions, patients were invited to conceive naturally. For the patients that laparoscopic investigation failed to reveal any pathology they were categorized as unexplained infertility and were subjected to a single IVF cycle. Natural conception success rate within the first postoperative year was the primary outcome. Within the first postoperative year, 30 out of 62 patients (48.38%) diagnosed with endometriosis following laparoscopic investigation achieved a natural conception, and 28 out of them (93.4%) reported live-births. Additionally, 11 out of 25 patients (44%) diagnosed with periadnixal and pelvic adhesions achieved natural conception within the first operative year. Regarding the group of unexplained infertility patients, only four out of the 20 patients (20%) achieved clinical pregnancy in the first post-operative IVF cycle. In conclusion, laparoscopy appears to be a promising approach, addressing infertility, providing significant diagnostic findings, while avoiding IVF overuse regarding patients of unidentified infertility presenting with recurrent failed IVF attempts.
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spelling pubmed-65179442019-05-31 The Role of Laparoscopic Investigation in Enabling Natural Conception and Avoiding in vitro Fertilization Overuse for Infertile Patients of Unidentified Aetiology and Recurrent Implantation Failure Following in vitro Fertilization Pantou, Agni Simopoulou, Mara Sfakianoudis, Konstantinos Giannelou, Polina Rapani, Anna Maziotis, Evangelos Grigoriadis, Sokratis Tsioulou, Petroula Syrkos, Stephen Souretis, Kyriakos Koutsilieris, Michael Pantos, Konstantinos J Clin Med Article The present study aims to explore the effectiveness of laparoscopic surgery on women presenting with infertility, of unidentified aetiology according to the standard infertility investigation, and recurrent failed In Vitro Fertilization (IVF) attempts. Identifying and correcting possible underlying pathologies by laparoscopy may subsequently enable natural conception in an effort to address infertility and avoid IVF overuse. One-hundred and seven (107) women with unidentified aetiology of infertility and recurrent failed IVF attempts met the inclusion criteria. Laparoscopic surgery was performed as the endpoint of the patients’ diagnostic journey, aiming to identify a possible underlying factor as the cause of infertility. Sixty-two (62) out of 107 patients (57.94%) that underwent laparoscopy were diagnosed with endometriosis, 25 out of the 107 patients (23.3%) were diagnosed with periadnixal and pelvic adhesions, and 20 cases (18.69%) presented with no pathology and remained unexplained. Following identification and correction of endometriosis and pelvic adhesions, patients were invited to conceive naturally. For the patients that laparoscopic investigation failed to reveal any pathology they were categorized as unexplained infertility and were subjected to a single IVF cycle. Natural conception success rate within the first postoperative year was the primary outcome. Within the first postoperative year, 30 out of 62 patients (48.38%) diagnosed with endometriosis following laparoscopic investigation achieved a natural conception, and 28 out of them (93.4%) reported live-births. Additionally, 11 out of 25 patients (44%) diagnosed with periadnixal and pelvic adhesions achieved natural conception within the first operative year. Regarding the group of unexplained infertility patients, only four out of the 20 patients (20%) achieved clinical pregnancy in the first post-operative IVF cycle. In conclusion, laparoscopy appears to be a promising approach, addressing infertility, providing significant diagnostic findings, while avoiding IVF overuse regarding patients of unidentified infertility presenting with recurrent failed IVF attempts. MDPI 2019-04-22 /pmc/articles/PMC6517944/ /pubmed/31013645 http://dx.doi.org/10.3390/jcm8040548 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pantou, Agni
Simopoulou, Mara
Sfakianoudis, Konstantinos
Giannelou, Polina
Rapani, Anna
Maziotis, Evangelos
Grigoriadis, Sokratis
Tsioulou, Petroula
Syrkos, Stephen
Souretis, Kyriakos
Koutsilieris, Michael
Pantos, Konstantinos
The Role of Laparoscopic Investigation in Enabling Natural Conception and Avoiding in vitro Fertilization Overuse for Infertile Patients of Unidentified Aetiology and Recurrent Implantation Failure Following in vitro Fertilization
title The Role of Laparoscopic Investigation in Enabling Natural Conception and Avoiding in vitro Fertilization Overuse for Infertile Patients of Unidentified Aetiology and Recurrent Implantation Failure Following in vitro Fertilization
title_full The Role of Laparoscopic Investigation in Enabling Natural Conception and Avoiding in vitro Fertilization Overuse for Infertile Patients of Unidentified Aetiology and Recurrent Implantation Failure Following in vitro Fertilization
title_fullStr The Role of Laparoscopic Investigation in Enabling Natural Conception and Avoiding in vitro Fertilization Overuse for Infertile Patients of Unidentified Aetiology and Recurrent Implantation Failure Following in vitro Fertilization
title_full_unstemmed The Role of Laparoscopic Investigation in Enabling Natural Conception and Avoiding in vitro Fertilization Overuse for Infertile Patients of Unidentified Aetiology and Recurrent Implantation Failure Following in vitro Fertilization
title_short The Role of Laparoscopic Investigation in Enabling Natural Conception and Avoiding in vitro Fertilization Overuse for Infertile Patients of Unidentified Aetiology and Recurrent Implantation Failure Following in vitro Fertilization
title_sort role of laparoscopic investigation in enabling natural conception and avoiding in vitro fertilization overuse for infertile patients of unidentified aetiology and recurrent implantation failure following in vitro fertilization
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6517944/
https://www.ncbi.nlm.nih.gov/pubmed/31013645
http://dx.doi.org/10.3390/jcm8040548
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