Preface

Since its first description by Steptoe and Edward, IVF gained popularity among both doctors and patients. There is many studies on assisted reproduction and they cover most of the related technical, laboratory as well as clinical aspects. To write a book on assisted reproduction nowadays seems very difficult due to a wide plethora of related papers and well-illustrated books. This small-sized book aims at refinement of some already known points of practical importance in infertility management particularly ART. Before advising couples to start a protocol of ART, gynecologists shouldn't ignore proper preoperative assessment of the female. A lot of money and stress can be eliminated if the patient has a proper combined laparoscopy and hysteroscopy. In this book, an unbiased stratification plan for every infertile case is demonstrated before referring her to ART. The established role of endoscopic preparation for ART is well addressed. Many failures can be prevented when a simple office hysteroscopy is performed before starting the cycle. Moreover, success can be increased by utilizing some assisted endoscopic embryo transfer techniques particularly in cases with recurrent implantation failure.

Induction of superovulation is a subject of debate particularly in poor responders. In this book, you will find that the inclusion of LH in the stimulation of poor responders and women thirty-five and older would improve ART outcomes. If you are an embryologist, you will enjoy reading a detailed chapter on technical updated tricks that would be very valuable in all steps of lab work. For clinicians, a modified technique of embryo transfer as well a detailed discussion of luteal phase support protocols will be address in two separate chapter.

In short, this book is tailored to add new ideas or tricks to different steps of ART. We hope it would serve as a foundation of valuable information to all gynecologists that they all find useful during ART day practice.

> **Dr. Atef M.M. Darwish, MD, PhD** Department of Obstetrics and Gynecology, Woman's Health University Hospital, Egypt

**Chapter 1** 

© 2012 Daru and Kereszturi, licensee InTech. This is an open access chapter distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2012 Daru and Kereszturi, licensee InTech. This is a paper distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

Laparoscopy is used world-wide to investigate infertility. It is a minimally invasive surgical technique used in infertility diagnosis and treatment and generally accepted that diagnostic laparoscopy is the gold standard in diagnosing tubal pathology and other intra - abdominal causes of infertility. Laparoscopic surgery has revolutionized gynecological surgery. In a female, the uterus, fallopian tubes and ovaries are located in the pelvis which is at the very bottom of the abdomen. Laparoscopy allows seeing abnormalities that might interfere with a woman's ability to conceive a pregnancy. Infertility diagnostic and operative laparoscopy help evaluate gynecological problems such as uterine fibroids, structural abnormalities of the uterus, endometriosis, ovarian cysts and adhesions. A large number of procedures can be performed laparoscopically. Most commonly it is used to inspect the pelvic organs (diagnostic laparoscopy), and often to perform surgical procedures (operative laparoscopy) at the same time. Complicated endometriosis, pelvic adhesions, removal of large ovarian cysts and fibroids should only be performed by highly skilled laparoscopic surgeons. The fiber-optic camera on the laparoscope is very small. It is inserted into the body, through an incision made in the nave, another incision may be made near the upper pubic region.

**The Role of Endoscopy** 

Jozsef Daru and Attila Kereszturi

*1.1.1. Methods, techniques and equipment* 

**1.2. Laparoscopy is often used for** 



http://dx.doi.org/10.5772/51094

**1. Introduction** 

**1.1. Laparoscopy** 

**in Management of Infertility** 

Additional information is available at the end of the chapter
