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Minimally Invasive Surgery
Volume 2015, Article ID 730513, 6 pages
http://dx.doi.org/10.1155/2015/730513
Clinical Study

Clinical Effectiveness of Modified Laparoscopic Fimbrioplasty for the Treatment of Minimal Endometriosis and Unexplained Infertility

1Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University Hospitals Case Medical Center, MacDonald Women’s Hospital, Cleveland, OH 44106, USA
2Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, The University of British Columbia, D415A, 4500 Oak Street, Vancouver, BC, Canada V6H 3N1
3Women’s Health University Center, Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
4Department of Biostatistics and Epidemiology, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA

Received 25 March 2015; Accepted 21 April 2015

Academic Editor: Peng Hui Wang

Copyright © 2015 Sarah E. Franjoine et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To study the reproductive outcomes of modified laparoscopic fimbrioplasty (MLF), a surgical technique designed to increase the working surface area of the fimbriated end of the fallopian tube. We postulated that an improvement in fimbrial function through MLF will improve reproductive outcomes. Design. Retrospective cohort study. Setting. Academic tertiary-care medical center. Patients. Women with minimal endometriosis or unexplained infertility, who underwent MLF during diagnostic laparoscopy () or diagnostic laparoscopy alone (). Intervention. MLF involved gentle, circumferential dilatation of the fimbria and lysis of fimbrial adhesions bridging the fimbrial folds. Main Outcome Measures. The primary outcome was pregnancy rate and the secondary outcome was time to pregnancy. Results. The pregnancy rate for the MLF group was 40.0%, compared to 28.7% for the control group. The average time to pregnancy for the MLF group was 13 weeks, compared to 18 weeks for the control group. The pregnancy rate in the MLF group was significantly higher for patients ≤35 ys (51.5% versus 28.8%), but not for those >35 ys (17.6% versus 28.6%). Conclusion. MLF was associated with a significant increase in pregnancy rate for patients ≤35 ys.