Keywords: transvaginal hydrolaparoscopy, hysterosalpingography, tubal patency test, fertility work-up

"Transvaginal hydrolaparoscopy- A clinical, economical and patient perspective"

Transvaginal hydrolaparoscopy (THL) is a tubal patency test that can be performed in an outpatient setting and that can evaluate whether the tubes are patent and if there is endometriosis or adhesions in the pelvic cavity. The main question for this thesis was if THL can be used as a first-line diagnostic test in the work-up of the subfertile couple.

This thesis found that unilateral tubal occlusion at THL does not affect the chance of a non-IVF pregnancy. Women with bilateral tubal occlusion, or with the combination of endometriosis and adhesions, have significantly reduced chances to have a non-IVF conception. In a randomised study we compared THL and hysterosalingography (HSG) (policlinical research of the uterus and the fallopian tubes) and found that THL was not inferior to HSG in terms of conception leading to life birth and THL is cost-effective compared to HSG. This thesis found that there was no difference in fertility related quality of life weeks after the procedure. In a discrete choice experiment (DCE) the preferences of subfertile women for different aspects of the tubal patency tests were examined.

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Language: Dutch