Table Of ContentSTUDIES IN
FERTILITY
AND
STERILITY
Diagnosis
and
Management
of
Tubo -Uterine
Factors
In
Infertility
STUDIES IN
FERTILITY
AND
STERILITY
Diagnosis
and
Management
of
Tubo -Uterine
Factors
.
In
Infertilit y
Edited by
R.F. Harrison, J. Bonnar
and WThompson
Themes from the Xlth World Congress on Fertility and Sterility,
Dublin, June 1983, held under the Auspices of the International
Federation of Fertility Societies
~ MTP PRESS LIMITED
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British Library Cataloguing in Publication Data
World Congress on Fertility and Sterility
(11th: 1983 : Dublin)
Diagnosis and management of tubo-uterine factors in infertility.-
(Studies in fertility and sterility)
1. Infertility, Female 2. Fallopian tubes 3. Uterus
I. Title II. Harrison, R. F. III. Bonnar, J
IV. Thompson, William, 1937-
V. International Federation of Fertility Societies
VI. Series 618.1' 78 RG201
ISBN-13: 978-94-011-7623-1 e-ISBN-13: 978-94-011-7621-7
DOl: 10.1007/978-94-011-7621-7
Published in the USA by
MTP Press
A division of Kluwer Boston Inc
190 Old Derby Street
~am,~O~,USA
Library of Congress Cataloging in Publication Data
Main entry under title:
Diagnosis and management of tubo-uterine factors in infertility
(Studies in fertility and sterility)
Includes bibliographical references and index.
1. Infertility-Etiology-Congresses. 2. Fallopian tubes-Diseases-Congresses.
3. Uterus-Diseases-Congresses. I. Harrison, R.F. (Robert Frederick) II. Bonnar, John.
III. Thompson, W. IV. World Congress of Fertility and Sterility (11th: 1983 : Dublin,
Dublin) V. International Federation of Fertility Societies. VI. Series.
[ONlM: 1. Fallopian Tube Diseases-congresses. 2. Infertility-etiology-congresses.
Copyright © 1984 MTP Press Limited
Softcover reprint of the hardcover Ist edition 1984
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Contents
Preface xi
List of Contributors xiii
PART I: THE ANIMAL OVIDUCT
Section 1: Physiology
1 The impact of tubal surgery on early embryonic development in the
rabbit oviduct 5
J. L. H. Evers, J. A. Land, R. Pijnenborg, W. D. Boech and
I. A. Brosens
2 Transport of proteins and water out of an artificial hydrosalpinx in the
rabbit 9
R. Wiedemann, P. Scheidel, F. P. Ehrling-Simke, C. Biro and H. Hepp
Section 2: Microsurgical Techniques
3 Ultrastructural changes of the mucosa in rabbit fallopian tube after
reanastomosis 17
S. Nitschke-Dabelstein, A. Boger, ]. E. Luttges and C. Zwiens
4 Quantitative morphometrical and histopathological study in rabbit
oviducts following microsurgical treatment 21
J. E. Luttges, A. Boger, C. Zwiens, U. Pudlo and S. Nitschke-Dabelstein
5 Reanastomoses of rabbit oviducts with monofilament and polyfilament
absorbable sutures - a histological study 27
C. Zwiens, A. Boger, J. E. Luttges and S. Nitschke-Dabelstein
6 Conventional sutures versus fibrin glue in microsurgical anastomosis of
reproductive tissue 31
D. Sojo, P. Cuevas and]. Cortes
v
TUBa-UTERINE FACTORS IN INFERTILITY
7 The tissue reaction to different kinds of suture material in the uterus and
the oviduct of the rabbit 35
P.]. Dorr, A. G. ]. M. Hanselaar, C.I. Herman, M. Boer-Meisel and
H.M. Vemer
8 Prevention of adhesions and restoring patency during oviduct
anastomosis in rabbits: microscope versus loupes 39
H. M. Vemer, W. Boeckx and I. Brosens
9 Inhibition of peritoneal adhesion formation by colchicine 43
M. Granat, I. Tur-Kaspa, E. Zylber-Katz and]. G. Schenker
10 Prevention of re-formation of pelvic adhesions by 'Barrier' methods 47
M. Yemini, A. Meshorer, Z. Katz, D. Rozenman and M. Lancet
PART II: TUBO-UTERINE INFECTION
11 Scanning electron microscopic studies on the changes of the oviduct due
to ageing, menstrual cycle, pregnancy and inflammation 53
T. Hashimoto, S. Kawakami, M. Morisada, T. Fujiwara and R. Iizuka
12 Chronic histological inflammation and Chlamydia trachomatis in
women selected for tuboplasties 59
]. De Brux, I. Henry-Suchet, P. Bussiere, A. Ardoin, F. Catalan,
D. Serfaty and V. Loffredo
13 Specific IgG and IgA antibodies to Chlamydia trachomatis in infertile
women 63
I. Sarov, D. Kleinman, R. Cevenini, G. Holcberg, G. Potashnik and
V. Insler
14 Tuberculosis of the female genital system 69
A. Comninos, E. Tsaminis, T. Lainas, M. AI-Achmar and S. Sarris
15 Resistant Ureaplasma urealyticum in infertile patients: a proposed
method of treatment 73
H. W. Horne, Ir. and R. B. Kundsin
16 Prevalence of Ureaplasma uralyticum in habitual spontaneous abortion 77
W. Foulon, A. Naessens, M. Volckaert and ],1. Amy
PART III: ENDOMETRIOSIS
Section 1: Pathophysiology
17 Aetiology of infertility in patients with endometriosis 85
S. Z. A. Badawy, M. Nusbaum, L. Marshall, V. Cuenca and
R. Cittadino
vi
CONTENTS
18 Peritoneal fluid 6-keto prostaglandin FlQ levels in women with
endometriosis 87
T. J. Mudge, W. R. Jones, J. A. Walsh and M. J. James
19 Decreased concentration of ovarian LH (hCG) receptor in polycystic
ovarian disease and endometriosis 95
A. Kauppila, H. Rajaniemi and L. Ronnberg
20 Autoimmune phenomena in infertile patients with endometriosis 101
S. Z. A. Badawy, V. Cuenca, A. Stitzel, R. D. B. Jacobs and
R.H. Tomar
Section 2: Therapy and Results
21 Endoscopic cytopuncture in the diagnosis of intraovarian endometriosis 105
M. Mintz and 1. De Brux
22 Objective assessment of medical treatment of endometriosis with
gestrinone (R2323) 111
1. c. Emperaire and A. J. M. Audebert
23 Treatment of infertility due to endometriosis with low-dosage danazol 117
C. Samaras, R. D. Gambrell, Jr. and R. B. Greenblatt
24 Endometriosis associated with hyperprolactinaemia 123
1. Abe, 1. Kimura, T. Tamaya and H. Okada
25 A newly designed conservative surgery for advanced pelvic
endometriosis 127
O. Sugimoto and K. Miyazaki
26 Surgical treatment of ovarian endometriosis 131
M. Perez-Pelaez, A. 1. Sobrero and R. S. Jeyendran
PART IV: TUBAL FACTOR DIAGNOSIS
Section 1: Clinical Results of Diagnostic Endoscopy
27 Laparoscopic findings in 801 sterile patients 139
C. Stadler, V. Maassen, G. Poehner and M. Stauber
28 Improved laparoscopic fertility testing 143
M. Stauber, V. Maassen, C. Stadler, H. Spielmann, M. Schwerdt,
C. Dincer, C. Krueger, E. Radke and R. Hartwig
29 Combined endoscopic findings in 682 infertile women and 135 women
requesting sterilization reversal 149
P. J. Taylor, A. Leader and H. A. Pattinson
vii
TUBO-UTERINE FACTORS IN INFERTILITY
Section 2: Endoscopic Results in Comparison with Other Techniques
30 Diagnostic evaluation of hysterosalpingography in infertile patients 155
H. Imaizumi, R. Mori, S. Uehara, K. Takahashi, H. Hoshiai and
M. Suzuki
31 Endoscopy of the tube (tuboscopy): its prognostic value compared with
hysterosalpingography 159
]. Henry-Suchet, V. Loffredo, L. Tesquier and]. P. Pez
32 Comparison between uterotubal insufflation, hysterosalpingography
and laparoscopy 163
L. Dessanti, A. M. S. Foscolu, G. B. La Sala, C. Cigarini, G. Ghirardini
and F. Valli
33 Diagnostic laparoscopy in primary infertility 167
J. Paavonen, M. Berg, M. Lahtinen and P. K. Heinonen
34 Laparoscopy in the investigation of subfertility 171
P. C. Wong, B. C. Doi, C. Anandakumar, M. Rauff and S. S. Ratnam
35 Laparoscopic findings in 375 women attending the Rotunda Hospital
Infertility Clinic 177
P. McKenna, M. Darling and R. Harrison
PART V: MICROSURGERY
Section 1: Case Selection
36 Contraindications to tubal restorative surgery. Proposal for a dissuasive
laparoscopic score 185
R. Palmer, G. Enault and D. Schmidt
37 The cytology of tubal secretions for selection of salpingostomies by
microsurgical technique 189
W. Albrich, C. Peters-Welte, A. Gotz and c.. Hammer
38 In vitro fertilization and embryo replacement in relation to tubal
surgery for infertility 193
P. Steptoe
39 Psychological issues in mechanical infertility 197
1. Eibschitz, M. Erdreich, K. de Vries, H. Shihor and M. Sharf
Section 2: Special Techniques
40 Danazol as an ovulation inhibitor prior to tubal surgery 203
L. Tesquier, ]. Henry-Suchet, T. Loysel, Y. Robert and V. Loffredo
41 Temporary ovarian suspension for prevention of recurrent adhesions
after salpingostomy 207
R. Palmer and E. Sedbon
viii
CONTENTS
42 Pregnancies after terminal microsurgical tuboplasties with early laparo-
scopic control on the eighth day 211
J. Henry-Suchet, A. Soler, F. X. Paris, J. Tort-Grumbach and
V. Loffredo
43 Laparoscopic and hysteroscopic CO2 laser procedures in infertility 215
Y. Tadir, 1. Kaplan, Z. Zuckerman and J. Ovadia
44 Microsurgical techniques for selective removal of tubocomual polyps 219
S. Gordts, W. Boeckx and I. Brosens
Section 3: Clinical Results
45 Therapy and long-term results after different operative procedures for
extrauterine pregnancy 225
M. Langer, M. Metka, W. Grnnberger and E. Kubista
46 Emergency microsurgery 229
I. Eibschitz, K. de Vries, M. Hakim and M. Sharf
47 Pelvic microsurgery in an Irish context 233
M. R. N. Darling
48 Microsurgical restoration of tuboperitoneal infertility in 125 women 235
S. Sarris, A. Comninos and K. Mavrelos
PART VI: UTERUS AND VAGINA
49 Hysteroscopy in infertility 241
/. Kavvos, S. Sarris and A. Comninos
50 Treatment of intrauterine adhesions 247
D. Navot, E. J. Margaloith, S. Mor-Joseff and J. G. Schenker
51 The place of metroplasty in the management of congenital uterine
malformation 251
P. R. Bowman, N. M. Duignan and A. T. Greene
52 Psychosexual consequences of Vecchietti's operation in
Rockitansky-Kiister-Hauser syndrome 255
P. Riss, K. Schieder, A. M. Rogan and H. Janisch
53 Canalization of mucus in human fertility 259
S. Campo, E. Giacchi, M. Messina, V. Panetta and N. Garcea
54 Treatment of cerVical mucus infection by means of doxycycline
polyphosphate in 53 hypofertile women 269
/. Buvat, M. Buvat-Herbaut, /. c. Fourlinnie, F. Desmons, C. Cuvelier,
/. C. Herbaut and A. Lemaire
Index 273
ix
Preface
This is the second compilation of papers given during the Related Communica-
tions Sessions of the XIth International Federation of Fertility Societies World
Congress held on June 26th-July 1st 1983 at the Royal Dublin Society, Dublin,
Ireland.
Except for Part I, where results of animal experimentations are gathered
together, the volume is concerned solely with studies in the human. The role of
infection and endometriosis in the aetiology and treatment of the tubo-
uteroperitoneal factor in infertility are the concern of Parts II and III.
Diagnostic and therapeutic aspects of tubal disease are covered in Parts IV and
V and the book ends with Part VI, chapters on the uterus and vagina.
Laparoscopy and microsurgical techniques have undoubtedly transformed
the diagnostic and therapeutic outlook in this area of infertility. This book
shows you how far such techniques have progressed and how much there is yet
to do.
Dublin, 1983 Robert F. Harrison
lohnBonnar
William Thompson
xi
List of Contributors
J. ABE 5. A. Z. BADAWY
Department of Obstetrics and Gynecology Department of Obstetrics and Gynecology
Kyoto Prefectural University of Medicine Upstate Medical Center
Kawarmachi-Hirokogi, Kamikyoku, Kyoto 750 E. Adams Street
JAPAN 602 Syracuse, NY 13210
USA
M.ALACHMAR
"Marika Eliadi" Maternity Hospital
2 Helena Venizelos Square M. BERG
Athens 115 21 Department of Clinical Sciences
GREECE University of Tampere
Teiskontie 35
W. ALBRICH SF-33520 Tampere
Department of Obstetrics and Gynecology FINLAND
University of Munich
Marchioninistrasse
D-8000 Munich 70 G. BIRO
WEST GERMANY University of Saarland
Department of Obstetrics and Gynecology
1.1. AMY D-6650 Homburg-Saar
Department of Obstetrics and Gynecology WEST GERMANY
Academisch Ziekenhuis - V.U.B.
Larbeeklaan 101
1090 Brussels W.D, BOECKX
BELGIUM Centre for Microsurgery
Academic Hospital De Gasthuisberg
C. ANANDAKUMAR University of Leuven
Department of Obstetrics and Gynaecology B-3000 Leuven
National University of Singapore BELGIUM
Kandang Kerbau Hospital
Hampshire Road
SINGAPORE 0821 M. BOER-MEISEL
Department of Obstetrics and Gynecology
A. ARDOIN Free University Hospital
Institut Pasteur de Boelelaan 1117
Paris 1007 NB Amsterdam
FRANCE THE NETHERLANDS
xiii
