ABSTRACT
In vitro fertilisation (IVF) has revolutionised many forms of fertility therapy, yet the question of IVF versus tubal surgery for mild to moderate tubal disease is sometimes still debated. IVF is a stressful and time-consuming treatment, and each attempt offers only a single chance for pregnancy, unless embryos can be frozen for future use. Successful tubal surgery, in contrast, can provide a permanent cure, with the possibility of more than one pregnancy. Furthermore, tubal surgery can be performed laparoscopically, although there is still debate about the respective indications for open tubal microsurgery and laparoscopic tubal surgery. It has been suggested that the only indication for open tubal surgery is reversal of sterilisation. In the United Kingdom, tubal surgery is often funded by the National Health Service, whereas IVF is to a much lesser extent. In our initial discussion, however, we propose to set aside the matter of cost and select the appropriate treatment for the individual patient.
