The objective of this study was to compare the use and effectiveness of laparoscopic and laparotomy oophorectomy in 3 hospitals in Melbourne. A retrospective analysis was made of medical records of 140 patients having laparoscopic or laparotomy oophorectomy in the Mercy Hospital for Women (41), Monash Medical Centre (37), and Cliveden Hill Private Hospital (62).Both public hospitals used the laparoscopic procedure, 12% and 22% respectively, less often than the private hospital, 94%. The average number of hospital days for procedures completed by laparoscopy was 1.3 and for laparotomy 6.9. Fourteen percent of laparoscopic procedures were converted to laparotomy. Adjusting for this the average hospital stay was 1.6 days for procedures started laparoscopically.Assuming 1,000 oophorectomies are performed each year in Australia of which 80% could be performed laparoscopically, there may be cost savings to health care providers of over $1.5 million. Laparoscopic oophorectomy is a safe, effective and cost‐efficient method of removing the ovary and gynaecologists should be encouraged to learn and perform this procedure.

BJOG: An International Journal of Obstetrics & GynaecologyVolume 93, Issue 1 p. 3-5 In-vitro fertilization and tubal microsurgery-their status compared C. Wood, C. Wood Chairman Department of Obstetrics and Gynaecology, Monash University, Queen Victoria Medical Centre, 172 Lonsdale Street, Melbourne, Victoria 3000, AustraliaSearch for more papers by this authorB. Downing, B. Downing Clinical Director of Cryobiology Department of Obstetrics and Gynaecology, Monash University, Queen Victoria Medical Centre, 172 Lonsdale Street, Melbourne, Victoria 3000, AustraliaSearch for more papers by this author C. Wood, C. Wood Chairman Department of Obstetrics and Gynaecology, Monash University, Queen Victoria Medical Centre, 172 Lonsdale Street, Melbourne, Victoria 3000, AustraliaSearch for more papers by this authorB. Downing, B. Downing Clinical Director of Cryobiology Department of Obstetrics and Gynaecology, Monash University, Queen Victoria Medical Centre, 172 Lonsdale Street, Melbourne, Victoria 3000, AustraliaSearch for more papers by this author First published: January 1986 https://doi.org/10.1111/j.1471-0528.1986.tb07803.xCitations: 1AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume93, Issue1January 1986Pages 3-5 RelatedInformation

During February 1979 to December 1983, 831 infertile couples were treated by in vitro fertilisation and embryo transfer. The problems they faced included deciding on the number of oocytes to be collected at laparoscopy, the numbers to be donated or fertilised, the numbers of embryos to be transferred and frozen, and whether abnormal embryos should be used for research or discarded. The 831 patients received a total of 1530 treatment cycles. Of the 763 patients for whom complete data were available, 136 (17.8%) became pregnant. The rate of pregnancy, however, increased dramatically from 7.4% when only one embryo was transferred to 21.1% and 28.1% when two and three embryos were transferred, respectively. The chance of multiple pregnancy also increased with the number of embryos transferred, but the risk (2% for twins) was far outweighed by the relatively poor result after transferring a single embryo. Out of 40 embryos freeze-thawed, 23 survived thawing and were transferred; of these, 4 (17%) resulted in pregnancy. Thirty four transfers of donor oocyte embryos also resulted in four pregnancies (12%), but two of these ended in abortion. Neither microscopy nor any other available test can determine the potential of an oocyte to result in pregnancy, so that discarding oocytes that may look abnormal simply reduces the chances of conception--both for the patient and for any prospective recipient of donor oocyte embryos. In any case, abnormal embryos tend to die when growth is allowed to continue in vitro. Probably all oocytes harvested from a patient should be inseminated and the utilisation of the embryos decided once the number developed is known.Four members of the Department of Obstetrics and Gynaecology, Monash University, Queen Victoria Medical Centre in Melbourne, Australia, present the clinical results of their treatment of 831 infertile couples by in vitro fertilization and embryo transfer. Decisions facing the couple may include the number of oocytes to be collected, donated to another woman, or fertilized; the number of embryos to be transferred to the uterus or frozen for future use; and whether abnormal embryos are to be used for research or discarded.

During February 1979 to December 1983, 831 infertile couples were treated by in vitro fertilisation and embryo transfer. The problems they faced included deciding on the number of oocytes to be collected at laparoscopy, the numbers to be donated or fertilised, the numbers of embryos to be transferred and frozen, and whether abnormal embryos should be used for research or discarded. The 831 patients received a total of 1530 treatment cycles. Of the 763 patients for whom complete data were available, 136 (17.8%) became pregnant. The rate of pregnancy, however, increased dramatically from 7.4% when only one embryo was transferred to 21.1% and 28.1% when two and three embryos were transferred, respectively. The chance of multiple pregnancy also increased with the number of embryos transferred, but the risk (2% for twins) was far outweighed by the relatively poor result after transferring a single embryo. Out of 40 embryos freeze-thawed, 23 survived thawing and were transferred; of these, 4 (17%) resulted in pregnancy. Thirty four transfers of donor oocyte embryos also resulted in four pregnancies (12%), but two of these ended in abortion. Neither microscopy nor any other available test can determine the potential of an oocyte to result in pregnancy, so that discarding oocytes that may look abnormal simply reduces the chances of conception--both for the patient and for any prospective recipient of donor oocyte embryos. In any case, abnormal embryos tend to die when growth is allowed to continue in vitro. Probably all oocytes harvested from a patient should be inseminated and the utilisation of the embryos decided once the number developed is known.Four members of the Department of Obstetrics and Gynaecology, Monash University, Queen Victoria Medical Centre in Melbourne, Australia, present the clinical results of their treatment of 831 infertile couples by in vitro fertilization and embryo transfer. Decisions facing the couple may include the number of oocytes to be collected, donated to another woman, or fertilized; the number of embryos to be transferred to the uterus or frozen for future use; and whether abnormal embryos are to be used for research or discarded.

A controlled study was carried out in the pig to determine the effect on fertility of resecting either the ampullary-isthmic junction or the isthmus. In both treated groups, the nidation index was lower than that in the control animals. The index was not significantly lower in the isthmic resection group than in the ampullary-isthmic junction group. The implications of these findings in terms of fallopian tube physiology and human tubal reconstructive surgery are discussed.

An unsuccessful human fallopian tube transplant is reported. A microsurgical technique is described which initially secured a viable transplant. However, the allograft subsequently died, probably as a result of rejection. Immunosuppression of the patient caused no complications or difficulties, the donor sharing one HL-A haplotype with the patient. The operative procedure, the risks of immunosuppression, and the ethical aspects of the case are discussed in order to present the problems associated with fallopian tube transplantation.

A series of patients requesting sterilization reversal has been reviewed. Microsurgical tubal anastomosis has been successfully employed and offers improved surgical results. Minimization of the length of tube damaged at sterilization procedures is probably a major factor in determining pregnancy rates should subsequent reversal be desired.

A pilot study was carried out to determine women's attitudes to various contraceptive methods. The adjectives unnatural, tense, messy, frightening, unsafe, repulsive, sad and difficult were chosen frequently by women to describe contraceptives whilst immoral, sinful and ill health were not. Attitudes to individual contraceptives were also determined and varied markedly. One in four women found all contraceptives frightening, so that emotional barriers to their use was common. The present technique may also be useful in studying social factors which may influence attitudes to contraceptives.

1.1. Fluctuations in numbers of Brent geese in relation to their food supply is discussed.2.2. At Scolt Head Island, Norfolk, Enteromorpha species are the main food of Brent geese, and Zostera nana, although locally abundant, is not always eaten when the tides make it available.3.3. Study of feeding habits supplemented by analysis of food remains in the droppings of the geese suggest that there is a distinct seasonal pattern of feeding correlated with the main growth periods of the different food plants.4.4. Evidence is given which suggests that the diet of Brent geese may be much more restricted in Hampshire harbours than it is in Norfolk and Essex.5.5. A feeding trial carried out on tame Pacific Brent (Branta branta nigricans) at the Wild-fowl Trust, Slimbridge, showed that analysis of the droppings gave a good approximation (±10 per cent.) of the proportions of food actually ingested.6.6. Nutritional analyses of the main foods of Brent geese and of droppings derived from these foods are reported.