**2.4. Advantages of laparoscopy over ART**

Excellent results.

28 Enhancing Success of Assisted Reproduction

Advantages

Disadvantages

**Expectant treatment**

Safe cheap

Anxiety

Unpredictable outcome

**Table 1.** Lines of infertility management

**2.3. Is surgery better than IVF?** 

pregnant (40%).

**2.2. Drawbacks of the expectant therapy** 

No strict criteria on which to base management decisions.

compared with IVF for women aged 40 years and above (2).

Hence, the likelihood of spontaneous pregnancy for each individual couple must be

**Endoscopic ART**





**management**




anatomy.

pregnancy.


**Logicstudies:** Microsurgical reversal of sterilization is a highly cost-effective strategy when

**Illogic studies**: some over enthusiastic studies demonstrated that endoscopy is much better than ART. In a bizarre study, Marana et al. (3) included 43 patientsand subjected them to diagnostic or operative laparoscopy. Nine of themwith submucous-intramural or multiple intramural fibroids underwent miomectomy by minilaparotomy following hysteroscopy and chromopertubation. The mean length of follow- up was 49 months (range: 11 to 118 months). They reported a very high pregnancy rate as 61 became

weighed against the potential benefits or risks of interventional treatment.


Tubal reconstructive surgery remains an important option for many couples and surgery should be the first line approach for a correct diagnosis and treatment of tubal infertility (4).
