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Massive ascites associated with endometriosis is uncommon. Recurrent episodes of bloody ascites as a result of endometriosis occurred in a woman with familial Mediterranean fever, who underwent therapy for induction of ovulation. Ovulatory agents may provoke accumulation of ascites in patients with endometriosis.

It is not fully understood how eggs are captured by the fallopian tube. The close proximity of tube and ovary, and the movements of the fimbria across the ovarian surface during ovulation, are believed to contribute to ovum pickup. We studied the efficiency of ovum capture when contact between fimbria and ovary is prevented and the extent to which ovum transmigration may contribute to fertility. Unilateral right oophorectomy was performed in 55 rabbits, which were divided into three groups: in Group A, the contralateral oviduct was left intact; in Group B, the ampulla of the contralateral oviduct was occluded; in Group C, contralateral total salpingectomy was performed. None of the rabbits in Group A conceived on the oophorectomized side. Seven of 19 animals became pregnant in Group B and 15 of 18 conceived in Group C. The results indicate that direct fimbrial-ovarian contact is not essential for ovum capture, and that ovum transmigration could contribute to fertility.

Ovairan implantation into the uterus was performed in 27 women, none of whom conceived during the 4- to 6-year follow-up period. Bypassing the fallopian tube may, in itself, explain the disappointing results of this procedure in our series as well as in those reported in the literature. Experimental ovarian implantation into the uterus of rats supplied information regarding additional factors underlying the low success rate of this operation. It is concluded that this surgical intervention has been made superfluous in view of the poor results and the modern methods for extracorporal fertilization at present being developed.

The results of 200 prenatal diagnoses following amniocentesis are summarized. The routine withdrawal of 40 to 45 ml amniotic fluid caused no increase in maternal morbidity, fetal loss, prematurity or congenital malformations. There were no culture failures and in all cases in which amniotic fluid was obtained the prenatal diagnosis was subsequently confirmed. Electron microscopy was used in the prenatal diagnosis of a newly described metabolic storage disease (mucolipidosis IV). Eleven abnormal fetuses and one male fetus at risk for hemophilia A were diagnosed and aborted.