**3.4. Standard diagnostic assessments**


The Role of Endoscopy in Management of Infertility 13

required in women who desire pregnancy and do not become pregnant on Clomid therapy (Gonadotropin injections, hCG , human chorionic gonadotropin, GnRH Lutrepulse).The primary indications for the use of CC is normogonadotropic normoprolactinemic anovulatory infertility i.e. PCOS. Approximately 70-80% of the women will ovulate half of

**Steroid hormones**: Oral contraceptives (birth control pills), Progesterone (bioidentical),

**Bilateral wedge resection** of ovaries were abandoned due to peri - ovarian adhesion formation. **Ovarian drilling:** Surgical procedure which can help induce ovulation in some women who have not responded to other treatments for PCOS. In this procedure a small portion of ovarian tissue is destroyed by an electric current delivered through a needle inserted into the ovary. This is less invasive technique and less chances of multiple Pregnancy and ovarian hyperstimulation. Laparoscopic Ovarian Drilling is a safe and cost effective

**Tubal infertility** includes the changes due to inflammation which affect the fallopian tube and its relation towards the ovary in a way that will affect ovulation, the transport of the egg, sperm, or embryo, or alter the function of the tube as the site of fertilization. Injury the distal oviduct resulting in a complete or partial occlusion is the most common tubal lesion. Microsurgical or laparoscopic repair is the primary method of treatment with pregnancy rates. Hydrosalpinges produces an adverse impact on results of *in vitro* fertilization. Removal of Hydrosalpinges will improve IVF success rates. The surgeon has to distinguish

which will conceive.

**Tubal factor** 

This are:

2. Hydrosalpinx.

**IVF** (in-vitro fertilization)

Estrogens, and Corticosteroids

**Physiology of the fallopian tube** 



The fallopian tube has complex task:

procedure and increases the sensitivity to gonadotrophins.


between the pathological findings according to the site which is affected.

1. Distal tubal obstruction (complete or incomplete)

3. Isthmo-cornual block (complete or incomplete). 4. Any combination of the previous three categories.

5. Peritubal or periovarian adhesions.

