%0 Journal Article
%T Tubal anastomosis: once in a blue moon? - Fertility and Sterility
%A Balasubramanian Bhagavath
%A Stephanie J. Estes
%A Steven R. Lindheim
%J Fertility and Sterility
%D 2018
%R https://doi.org/10.1016/j.fertnstert.2018.03.024  https://doi.org/10.1016/j.fertnstert.2018.02.139
%X Reflecting imparts the pleasant memory of something special, notable and memorable. In the past century, ¡°blue moon¡± has been used to denote the moment where a second full moon occurs within a calendar month, which happens once in three years. However, two blue moons in a year is quite rare. Just this year, we had the unique opportunity to see blue moons in both January and March. Owing to the metonic cycle, we will not experience two of these in the same year again until 2037. As with the blue moon, we ask whether tubal anastomosis has become too infrequent of a distinctive event to be worth remembering, offering, or teaching? In the current issue of Fertility and Sterility, the article by Lui et al. (1x1Liu, J., Bardawil, E., Lin, Q., Liang, B., Wang, W., Wu, C. et al. Transvaginal NOTES tubal reanastomosis: a novel route for tubal surgery. Fertil Steril. 2018; 110: 181 Abstract | Full Text | Full Text PDF | Scopus (2) | Google ScholarSee all References)(1), led us to reflect on the topic of tubal anastomosis and its role in our patients' care. Lui et al. (1x1Liu, J., Bardawil, E., Lin, Q., Liang, B., Wang, W., Wu, C. et al. Transvaginal NOTES tubal reanastomosis: a novel route for tubal surgery. Fertil Steril. 2018; 110: 181 Abstract | Full Text | Full Text PDF | Scopus (2) | Google ScholarSee all References)(1) eloquently display a transvaginal technique for tubal anastomosis combined with single-site surgical skills to demonstrate an innovative, feasible, and alternate method to this procedure. In seeing this variation, it is thought provoking to contemplate the evolution of the technical advances in tubal surgery and ponder the current state of the reproductive endocrinology and infertility (REI) surgeon. How worthwhile a certain surgery is and how best to foster minimally invasive surgical skills in obstetrics and gynecology residents/REI fellows are interesting issues. Despite the global effort to dissuade women from choosing tubal ligation for contraception, ¡«25% of women aged 15¨C44 years have undergone this surgery. In total, ¡«200 million women worldwide use female sterilization for contraception. When we account for the probability of sterilization regret being ¡«20% for women ¡Ü30 years of age, the enormous need for methods to achieve future fertility after tubal ligation is amply demonstrated (2x2Stuart, G.S. and Ramesh, S.S. Interval female sterilization. Obstet Gynecol. 2018; 131: 117¨C124 PubMed | Google ScholarSee all References)(2). Tubal microsurgery has a rich history, and despite the advances of in vitro fertilization (IVF),
%U https://www.fertstert.org/article/S0015-0282(18)30279-6/fulltext