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© 2012 Darwish, 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. | Chapter 2 Endoscopy versus IVF The Way to Go Atef Darwish Additional information is available at the end of the chapter http dx.doi.org 10.5772 51825 1. Introduction 1.1. Outlines - Role of endoscopy in infertility. Microsurgical principles reconstructive concept. - Can endoscopy omit ART - Endoscopy Vs ART - Advantages of ART over Endoscopy - Fertility enhancing procedures Laparoscopic adnexal surgery. Salpingoscopy Hysteroscopy - Endoscopy prior to ART routine hysteroscopy role of laparoscopy tubes with or withour hydrosalpnix and paratubal cysts endometrioma . - Endoscopically-assisted ART. - Endoscopy for recurrent implantation failure. - Future of endoscopy in the era of ART and keynote points. 2. Current approaches for infertility management In modern practice three schools are competitors for infertility management namely expectant endoscopic and assisted reproductive techniques ART approaches. There are no RCTs that compare the effectiveness of surgery againsteither IVF or expectant management. The following table demonstrates pros and cons of each approach 1 . 2.1. Rationale of expectant therapy Any treatment should be compared to expectant therapy. INTECH open science I open minds 2012 Darwish 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. 28 Enhancing Success of Assisted Reproduction Expectant treatment Endoscopic management ART Advantages Safe cheap -Restores normal anatomy. -Enhances natural pregnancy. -Long-term results -Time saving Excellent results Disadvantages Anxiety Unpredictable outcome - expensive additional -specialist training -- experience -adverse effects including ectopic pregnancies and operative risks. -Unpredictable outcome -Stress - Expensive - Risky -ohsS -Unpredictable outcome - Per trial result. Table
