Place of endoscopic exploration in the management of idiopathic infertility : data from the literature and meta-analysis of 25 studies ; Place de l’exploration endoscopique dans la prise en charge de l’infertilité idiopathique : données de la littérature et méta-analyse de 25 études

Nowadays, there is no clear recommendation concerning the Endoscopic Exploration (EE) for thefor management of Idiopathic Infertility (II). The main objective is to define the value of performing an EE after normal minimum infertility assessment. The secondary objective is to assess the risk benefit and to develop a therapeutic strategy in the management of couples with II. A review of the literature was carried out on 25 studies. They concerned couples with II after complete workup. All women benefited from EE. The judgment criterion studied was the rate of pathology found and/or the incidence of pregnancy obtained, during the study period A total of 3827 patients were included in the study. Performing EE in the management of II, significantly increases subsequent pregnancy ( OR=1,70 and [IC95% 1,3 ;1,94]). Primary infertility and the duration of infertility of less than 3 years would increase the chances of finding a pathology on laparoscopy (OR = 1.78 and 1.6). Performing first-line surgery, would increase the incidence of pregnancy (OR = 1.44 and [IC95% 1,14-1,97 ]). Finally, the pregnancy rate also seems better when an expectant attitude or the realization of AI is done after EE (OR = 4.9 and 1.8 respectively). The value of EE should be reconsidered in the management of II. The therapeutic strategy and therefore the place of this examination in the infertility assessment and the MAP course of the couples concerned will depend on several parameters. ; De nos jours, il n’existe pas de recommandation clairement établie concernant la réalisation d’une Exploration Endoscopique (EE) dans la prise en charge de l’Infertilité Idiopathique (II) . L’objectif principal est de définir l’intérêt de la réalisation d'une EE après bilan d’infertilité minimum normal. L’objectif secondaire est d’en évaluer le bénéfice-risque et d’élaborer une stratégie thérapeutique dans la prise en charge des couples avec II. Une revue de la littérature a été faite sur 25 études. Elles concernaient des couples avec une II après bilan ...