Minimally invasive surgery in assisted conception.

Minimally invasive surgery enables the avoidance of, preparation for, participation in, and treatment of complications following assisted reproductive technology (ART). The major recent changes are, the development of surgical techniques to diagnose and treat intrafallopian tubal abnormalities; the use of operative endoscopy to avoid radical surgery in the treatment of severe endometriosis and large myomas; the use of endoscopy in the selection of patients for ART; the extension of gamete intrafallopian transfer (GIFT) procedures to include operative laparoscopy for endometriosis and adhesions; the ability to collect unripe oocytes from small follicles, thereby reducing the need for stimulated ovarian cycles in patients with polycystic ovaries; the ability to produce normal pregnancies from the intra-oocyte injection of a single sperm, which facilitates the treatment of severe male infertility; and the development of a promising technique to transfer an embryo to the uterus through the myometrium, thereby avoiding the cervical canal.