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The incidence of mechanical factor infertility ranges from 7 to 18%, with the variability mostly associated with geography and the developmental status of the country.. Investigation can be done using a variety of diagnostic tests and procedures and the objective of the survey bellow is to share information on diagnostic procedures used.

Number of units participating in the survey. Most of the data analyzed came for Europe.

Continent

IVF Cycels

%

Number of units

%

USA & Canada

17900

17.0

24

16.4

South America

6100

5.8

22

15.1

Australia & New Zeland

7400

7.0

5

3.4

Asia

29600

28.2

35

24.0

Europe

40600

38.7

53

36.3

Africa

3400

3.2

7

4.8

Total

105000

 

146

 

 

graph1

In most of the cases the Hysterospalingogram is the diagnostic tool of choice.

graph2

Interesting to find that 50% of the participants would evaluate tubal patency even though they are aiming to proceed with IVF. That may include, for example, patients with severe male factor infertility.

graph3

Although diagnostic hysteroscopy is considered the gold standard for evaluating the uterine cavity, it interesting to note that there is no clear consensus among practicing physicians regarding the method of choice for uterine cavity evaluation. There is a clear split in preference of diagnostic technique. Perhaps the question was not specific enough and some of the respondents referred to initial and definitive diagnostic steps.

Do you perform reproductive surgery for patients with tubal obstruction? 
YES 44%
NO 56%

 

 

 

 

Interesting observation, but the question is perhaps not detailed enough to evaluate the conditions which are considered as an indication for surgical intervention. 

 

graph4

It seems that there is an agreement to have septum removal before getting into IVF. Interesting because this is not evidenced-based.

graph5

The answer here may depend of the cost, insurance coverage and availability of either IVF or microsurgery.

graph6

Even though saplingectomy is evidence-based 49% would prefer different modes of treatment

graph7

Most physicians will ignore a small endometrioma

If you perform laparoscopic surgery for infertility patients, what percentage of the time is it robotic-assisted? 
None 91
Less than 5% 9

 

 

 

 

It looks as if this is  a simple type of surgery that does not justify the use and cost of  robotic technology

 

In light of the possibility of using a surrogate mother, do you think it is worthwhile to put efforts into developing a method of uterine transplant? 
YES 48
NO 52