OBGYN.net Conference CoverageFrom ISGE - Montreal, Canada - April, 1999
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"Hi, I'm Mark Surrey from Los Angeles, California, speaking to you from Montreal, Canada, once again about some of the clinical implications of a procedure called transvaginal hydrolaparoscopy. We have been utilizing this as a primary diagnostic procedure to essentially replace indirect radiologic procedures like hysterosalpingograms by moving up the time frame between diagnoses and therapy for the infertility patients. In particular, this applies to older patients, where we have clearly shown, as have other authors, a poor correlation between the clinical findings of hysterosalpingography for evaluation of the tubal factor and laparoscopy.
Traditionally, laparoscopy has been thought of as a somewhat invasive procedure, however, requiring general anesthesia, intubation, and outpatient hospital format. Thus, if we can offer patients a less invasive, cost-effective process by which we can develop and gather more information about the distal tubo-ovarian hiatus and, therefore, the tubo-ovarian pick-up mechanism, we can triage patients - particularly the older patients - to either IVF or controlled ovarian stimulation in a more rapid and more appropriate fashion. Therefore, we speed up the time between a diagnostic procedure and the appropriate therapy. As we have shown and seen in IVF statistics, advancing maternal age has a significant adverse effect on fertility and, thus, anything we can do to minimize the time between diagnosis and therapy is going to be a great benefit to these patients.