In vitro fertilization and microsurgery

The places microsurgery and in vitro fertilization (IVF) hold, respectively, in the treatment of tubal infertility are evaluated. "Optimal" and "acceptable" results of the two techniques are compared, and future results are talked about. Most of the indications for microsurgery are still valid, some are debatable (salpingostomies with bad prognosis, repeated surgery, tubal transplant, etc.), and some new ones emerge. Technically speaking, IVF introduces some changes in surgery of the ovary and surrounding tissues and gives rise to new techniques. Diagnostic and therapeutic management is changed insofar as initial assessment, preoperative coelioscopy and, above all, postoperative monitoring are concerned. The microsurgeon, who is to remain a reproduction specialist, undergoes few personal changes, but his team must be organized on a multi-field basis in order to cope with the new techniques.