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Key content: Advances in histopathology, immunohistochemistry and molecular genetics have led to evidence that the fimbrial end of the fallopian tube may be the source of origin of non‐uterine high‐grade pelvic serous carcinoma (HGPSC).Most of the evidence comes from studies in risk‐reducing salpingo‐oophorectomy in BRCA carriers.A proportion of these high‐grade tumours have been proven to develop from specific precursor lesions, such as serous tubal intraepithelial carcinoma (STIC), before transformation into invasive high‐grade pelvic serous carcinoma.Detailed sectioning of the fallopian tube is suggested using the SEE‐FIM protocol (Sectioning and Extensively Examining the Fimbriated end of the fallopian tube).Clinical management of STIC in the absence of malignancy is not yet clearly defined. Learning objectives: To review the various theories of pathogenesis of non‐uterine HGPSC.To discuss the clinical management of STIC.Preventative strategies for HGPSC. Ethical issues: Role for salpingectomy as a mode of sterilisation in women with completed family and salpingectomy during hysterectomy for benign cases.Could risk‐reducing salpingectomy be recommended instead of risk‐reducing salpingo‐oophorectomy in young women, to avoid menopausal side effects? [ABSTRACT FROM AUTHOR]

Key content Introduction to preoperative classification of ovarian and tubal neoplasms., A discussion of existing guidelines by professional societies., Updated evidence and new strategies for preoperative diagnosis of ovarian cancer., Evidence-based recommendations for the diagnosis and characterisation of adnexal masses., Areas of future interest in the field of adnexal tumour diagnosis., Learning objectives To understand the importance of accurate preoperative discrimination of adnexal tumours to ensure optimal patient management., To critically appraise current guidelines by professional societies., To discuss findings from a recent systematic review and meta-analysis, and two diagnostic accuracy studies comparing different types of prediction models for ovarian cancer diagnosis., To understand the advantages and disadvantages of different International Ovarian Tumour Analysis ( IOTA) prediction models., Ethical issues Consequences of misclassification of ovarian and tubal masses., Inappropriate use of IOTA prediction models. [ABSTRACT FROM AUTHOR]

Key content The pathogenesis of infertility is multi-factorial; investigative and treatment approaches should therefore be individualised., There are many tests for tubal patency with their relative usefulness, but none address all aspects of tubal function., There is often a clear need for in vitro fertilisation (IVF) in the management of infertility., This article reviews the current best available evidence and provides an expert insight on the role of tubal patency tests in the era of assisted reproductive techniques (ART)., Learning objectives To understand the relative advantages and limitations of laparoscopy, hysterosalpingogram, hysterosalpingo contrast sonography, selective salpingography and tubal catheterisation, trans-vaginal hydrolaparoscopy, salpingoscopy and fertiloscopy as tests for tubal patency., To understand the role of Chlamydia trachomatis serology in tubal patency testing., To evaluate the role of tubal patency test in the hierarchy of investigations for infertility., To understand the role of tubal surgery in modern management of infertility., To understand the importance of medical history taking in infertility., Ethical issues Counselling patients about benefits and risks of tests, surgery and need for assisted conception., Should primary care trusts fund tubal surgery in patients who are not otherwise eligible for IVF?, There may be psychosocial issues or anxiety so a multidisciplinary approach is important. [ABSTRACT FROM AUTHOR]

Key content Assisted conception technology such as in vitro fertilisation ( IVF) is the first-line treatment of many causes of female subfertility and surgery is offered primarily to optimise the outcome of such treatments., An awareness and understanding of the evidence about the different surgical interventions used prior to assisted conception is essential in achieving the best possible outcome., Learning objectives To assess the fertility needs of women including the need for surgery., To understand the role of different surgical interventions prior to assisted conception for the management of hydrosalpinx, uterine fibroids, uterine pathology such as a uterine septum and intrauterine adhesions, and the treatment of endometriosis and ovarian endometriomas., Ethical issues Women should be counselled about the benefits and risks of surgery including the risk of delay to their assisted conception., A sympathetic approach is needed for women who are already emotionally and physically stressed., There are financial implications involved in IVF treatment., Psychosocial issues and anxiety require a multidisciplinary approach. [ABSTRACT FROM AUTHOR]