By Ann Westmore (auth.), Carl Wood CBE, FRCS, FRCOG, FRACOG, Alan Trounson MSc, PhD (eds.)
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Postoperative laparoscopy is undertaken to determine whether the adhesolysis has been successful. Patients who decline ovariolysis, or whose ovaries cannot be made accessible by ovariolysis, may enter an IVF programme where donated ova are fertilized by the husband's spermatozoa. 3 Length of Previous Menstrual Cycles All patients are requested to record the length of their menstrual cycles. The statistical prediction of the day of LH peak (McIntosh et al. 1980) is used to determine when LH assays should commence.
If the fallopian tubes are irreversibly damaged, it is recommended that salpingectomy be performed so that the diseased tube will not obscure the ovary. It is our practice to perform ovariopexy by fixing the ovarian ligament, or by fixing the ovary to the fundus of the uterus or to the round ligament; uterine fixation is best for subsequent ultrasonic scanning of the ovary. Which procedure is adopted depends on the circumstances, and it is important that the ovary does not become immovable because it may be necessary to manipulate the ovary during laparoscopy so that the complete surface can be inspected for follicles.
The child would then be given to the infertile couple. Surrogacy has not yet been approved by the QVMC Ethics Committee and the National Health and Medical Research Council of Australia. The use of the surrogate would require manipulation of the surrogate's cycle to coincide with the donor. This could be achieved by shortening or lengthening the menstrual cycle of the surrogate by appropriate use of progestogens. 8 Absence of Uterus and Ovaries Patients who have neither the uterus nor ovaries have requested AID, using the infertile husband's spermatozoa, to inseminate a surrogate.