[Tubal sterility: fertilization in vitro or microsurgery]

In this review paper the respective places of microsurgery and in vitro fertilization in the treatment of tubal infertility are evaluated. The best and current results of the two methods are compared and their future is considered. Most of the indications for microsurgery remain, while some (e.g. poor prognosis salpingostomy, repeated tuboplasty, tubal transplantation) require discussion and new ones are appearing. The advent of in vitro fertilization has introduced some technical changes in surgery of the ovaries and surrounding tissues and has given rise to new techniques. It has also modified the initial investigations in infertile women and the use of pre-operative and second-look laparoscopy. It has exerted little influence on microsurgeons specialized in problems of reproduction but has obliged their teams to be reorganized on a multidisciplinary basis in order to cope with new techniques.