Book contents
- Frontmatter
- Contents
- Contributors
- Foreword
- Preface
- Introduction
- PART I PHYSIOLOGY OF REPRODUCTION
- PART II INFERTILITY EVALUATION AND TREATMENT
- 6 Evaluation of the Infertile Female
- 7 Fertiloscopy
- 8 Microlaparoscopy
- 9 Pediatric and Adolescent Gynecologic Laparoscopy
- 10 Laparoscopic Tubal Anastomosis
- 11 Tubal Microsurgery versus Assisted Reproduction
- 12 The Future of Operative Laparoscopy for Infertility
- 13 Operative Hysteroscopy for Uterine Septum
- 14 Laser in Subfertility
- 15 Ultrasonography of the Endometrium for Infertility
- 16 Ultrasonography of the Cervix
- 17 Transrectal Ultrasonography in Male Infertility
- 18 The Basic Semen Analysis: Interpretation and Clinical Application
- 19 Evaluation of Sperm Damage: Beyond the WHO Criteria
- 20 Male Factor Infertility: State of the ART
- 21 Diagnosis and Treatment of Male Ejaculatory Dysfunction
- 22 Ovulation Induction
- 23 Clomiphene Citrate for Ovulation Induction
- 24 Aromatase Inhibitors for Assisted Reproduction
- 25 Pharmacodynamics and Pharmacokinetics of Gonadotrophins
- 26 The Future of Gonadotrophins: Is There Room for Improvement?
- 27 Ovarian Hyperstimulation Syndrome
- 28 Reducing the Risk of High-Order Multiple Pregnancy Due to Ovulation Induction
- 29 Hyperprolactinemia
- 30 Medical Management of Polycystic Ovary Syndrome
- 31 Surgical Management of Polycystic Ovary Syndrome
- 32 Endometriosis-Associated Infertility
- 33 Medical Management of Endometriosis
- 34 Reproductive Surgery for Endometriosis-Associated Infertility
- 35 Congenital Uterine Malformations and Reproduction
- 36 Unexplained Infertility
- 37 “Premature Ovarian Failure”: Characteristics, Diagnosis, and Management
- PART III ASSISTED REPRODUCTION
- PART IV ETHICAL DILEMMAS IN FERTILITY AND ASSISTED REPRODUCTION
- Index
- Plate section
- References
14 - Laser in Subfertility
from PART II - INFERTILITY EVALUATION AND TREATMENT
Published online by Cambridge University Press: 04 August 2010
Book contents
- Frontmatter
- Contents
- Contributors
- Foreword
- Preface
- Introduction
- PART I PHYSIOLOGY OF REPRODUCTION
- PART II INFERTILITY EVALUATION AND TREATMENT
- 6 Evaluation of the Infertile Female
- 7 Fertiloscopy
- 8 Microlaparoscopy
- 9 Pediatric and Adolescent Gynecologic Laparoscopy
- 10 Laparoscopic Tubal Anastomosis
- 11 Tubal Microsurgery versus Assisted Reproduction
- 12 The Future of Operative Laparoscopy for Infertility
- 13 Operative Hysteroscopy for Uterine Septum
- 14 Laser in Subfertility
- 15 Ultrasonography of the Endometrium for Infertility
- 16 Ultrasonography of the Cervix
- 17 Transrectal Ultrasonography in Male Infertility
- 18 The Basic Semen Analysis: Interpretation and Clinical Application
- 19 Evaluation of Sperm Damage: Beyond the WHO Criteria
- 20 Male Factor Infertility: State of the ART
- 21 Diagnosis and Treatment of Male Ejaculatory Dysfunction
- 22 Ovulation Induction
- 23 Clomiphene Citrate for Ovulation Induction
- 24 Aromatase Inhibitors for Assisted Reproduction
- 25 Pharmacodynamics and Pharmacokinetics of Gonadotrophins
- 26 The Future of Gonadotrophins: Is There Room for Improvement?
- 27 Ovarian Hyperstimulation Syndrome
- 28 Reducing the Risk of High-Order Multiple Pregnancy Due to Ovulation Induction
- 29 Hyperprolactinemia
- 30 Medical Management of Polycystic Ovary Syndrome
- 31 Surgical Management of Polycystic Ovary Syndrome
- 32 Endometriosis-Associated Infertility
- 33 Medical Management of Endometriosis
- 34 Reproductive Surgery for Endometriosis-Associated Infertility
- 35 Congenital Uterine Malformations and Reproduction
- 36 Unexplained Infertility
- 37 “Premature Ovarian Failure”: Characteristics, Diagnosis, and Management
- PART III ASSISTED REPRODUCTION
- PART IV ETHICAL DILEMMAS IN FERTILITY AND ASSISTED REPRODUCTION
- Index
- Plate section
- References
Summary
INTRODUCTION
The use of laser for fertility-conserving and fertility-enhancing surgery has gone through extensive debate during the past two decades. Most of the arguments against was the lack of concrete evidence for its superiority in the form of multicenter randomized trials that would justify the cost of this highly efficient precise surgical instrument (1). However, the efficacy and the ease of use have made the laser one of fertility surgeon's favorite. As with all surgical procedures, the most suitable is the one the surgeon is most comfortable with. Which tool a surgeon should use for the operation remains the subject of randomized trials to be conducted. In this chapter, we are going to give a brief description of the physical principles and the applications of the most commonly used lasers in subfertility surgery and provide evidence when it is available.
PHYSICS
Laser stands for light amplification by stimulated emission of radiation. The principle of the production of a laser beam is based on Einstein's theory of stimulated emission; an atom can be stimulated by an energy form – heat, electrical discharge, or photon bombardment – and stays stimulated for a calculated period of time. It then returns to its unstimulated state by emitting a photon, which is practically a light wave packet, one wave of light characteristic of the quality of the atom that was stimulated.
Keywords
- Type
- Chapter
- Information
- Infertility and Assisted Reproduction , pp. 132 - 136Publisher: Cambridge University PressPrint publication year: 2008
References
et al. Laser hysteroscopic myomectomy guided by laparoscopically assisted intra-abdominal sonohysterography (LHMY-GLAIS): a preliminary report. 2001;17(3): 79–86.Google Scholar
, , et al. Carbon dioxide laser and electrosurgical wound study with an animal model. A comparison of healing pattern and tissue damage in peritoneal tissue. Am J Obstet Gynecol 148:327.CrossRef
, , . Surgical treatment of endometriosis via laser laparoscopy. Fertil Steril 45:778–83.
Green Top Guideline No 24. The Investigation and management of Endometriosis RCOG, October 2006.
, , , , . Excisional surgery versus ablative surgery for ovarian endometriomata (Cochrane Review). Cochrane Lib 2006;(3).Google Scholar
. The endometriosis syndromes: a clinical classification in the presence of aetiological confusion and therapeutic anarchy. Hum Reprod 2004;19:760–8.CrossRefGoogle ScholarPubMed
. Laser laparoscopy in the treatment of endometriosis. A 5-year study. Br J Obstet Gynaecol 1990;97(2):181–5.CrossRefGoogle ScholarPubMed
, , et al. Techniques for pelvic surgery in subfertility. Cochrane Database Syst Rev. 2006;(2).CrossRefGoogle ScholarPubMed
. Pelviscopic adhesiolysis in chronic pelvic pain—laser versus conventional techniques. Geburtshilfe Frauenheilkd 1992;52(1):47–50.CrossRefGoogle ScholarPubMed
, , , . Techniques for pelvic surgery in subfertility (Cochrane Review). Cochrane Database Syst Rev 2006; (2).CrossRefGoogle Scholar
, , , . Adhesion reformation after reproductive surgery by videolaseroscopy. Fertil Steril 1990;53:1008.CrossRefGoogle ScholarPubMed
. Argon laser laparoscopy for treatment of pelvic endometriosis associated with infertility and pelvic pain. J Gynecol Surg 1991;7(1):27–32.CrossRefGoogle ScholarPubMed
. The value of two stage laser treatment for severe Asherman's syndrome. Br J Obstet Gynaecol 1996;103(12):1256–8.CrossRefGoogle ScholarPubMed
. , , , . Neodymium: YAG laser hysteroscopy in large submucous fibroids. Fertil Steril 1990;54:999–1003.CrossRefGoogle ScholarPubMed
. New therapeutic technique for treatment of uterine leiomyomas using laser-induced interstitial thermotherapy (LITT) by a minimally invasive method. Lasers Surg Med 1998;22(3):171–8.3.0.CO;2-M>CrossRefGoogle Scholar
, . Laser hair reduction in the hirsute patient: a critical assessment. Hum Reprod Update 2002;8(2):169–81.CrossRefGoogle ScholarPubMed
. Hysteroscopic metroplasty of the Class Va uterus with preservation of the cervical septum. Fertil Steril 1999;72(5):942–5CrossRefGoogle ScholarPubMed
. Transvaginal, ultrasound-guided, ovarian, interstitial laser treatment in anovulatory women with clomifene-citrate-resistant polycystic ovary syndrome. BJOG 2006;113(7):810–16.CrossRefGoogle ScholarPubMed
et al. No advantage of laser assisted hatching over conventional intracytoplasmic sperm injection; a randomized controlled trial. J Exp Clin Assist Reprod Biomed Central.