Rationale of first-line endoscopy-based fertility exploration using transvaginal hydrolaparoscopy and minihysteroscopy.
The transvaginal access for exploration of tubo-ovarian function in women with unexplained infertility has been revived since transvaginal hydrolaparoscopy (THL) was introduced in 1998. One prospective double-blind trial and several reviews have validated the diagnostic value of THL in comparison with laparoscopy for the exploration of women with unexplained infertility. A review of the recent literature confirms the efficacy and safety of the technique for first-line endoscopy-based exploration of fertility. The standard policy of 1-year delay for laparoscopic investigation in unexplained infertility is challenged. In older women and particularly in women experienced in fertility awareness methods, THL and minihysteroscopy can be performed after a waiting period of 6-12 months.
Pius-Hospital, Oldenburg,  Germany.
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De Wilde
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Brosens
D000328:Adult; D002986:Clinical Trials as Topic; D004715:Endometriosis / Q000175:diagnosis; D004724:Endoscopy / Q000379:methods*; D005184:Fallopian Tube Diseases / Q000175:diagnosis; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D007247:Infertility, Female / Q000175:diagnosis*; D010535:Laparoscopy / Q000379:methods*; D010049:Ovarian Diseases / Q000175:diagnosis; D010053:Ovary / Q000473:pathology