Introduction and outline of thesis[-][-]Chapter 1 The position of laparoscopy in current fertility practice.[-] [-][-]Chapter 2 The effectiveness of hysteroscopy for improving pregnancy rates in subfertile women: a systematic review.[-] [-]Chapter 3 Hysteroscopy for treating subfertility associated with suspected major uterine cavity abnormalities.[-] [-]Chapter 4 Anti- adhesion barrier gels following operative hysteroscopy for treating female subfertility: a systematic review and meta-analysis.[-] [-][-]Chapter 5 Anti-adhesion therapy following operative hysteroscopy for treating female subfertility.[-] [-]Chapter 6 Has there been any progress in evidence-based practice in reproductive surgery?[-] [-][-] Thesis summary and discussion[-] Samenvatting proefschrift en discussie[-][-]Appendices Abbreviations[-][-] Co- authors and affiliations[-][-] List of publications[-] [-] PhD Portfolio[-][-] Dankwoord[-][-] Curriculum Vitae[-]In the present doctoral thesis the evidence-based fundament for the shift from tubal reconstructive surgery to ART for treating tubal infertility is investigated. There is no randomised comparison between ART and reconstructive tubal surgery. Doing a laparoscopy in all cases of subfertility is not sensible given the availability of alternative and reliable diagnostic procedures to study tubal patency. The effectiveness of hysteroscopy for treating female subfertility is limited to some specific indications. There are many knowledge gaps in our current understanding of the effectiveness of hysteroscopic interventions in the treatment of subfertile women. These should be studied preferably by pragmatic randomized studies. The use of anti-adhesion barrier gels may decrease the incidence and the extent or severity of intrauterine adhesions following hysteroscopic surgery in subfertile women, but data on pregnancy and live birth rates are missing. Recent years have witnessed an increase in the number and the methodological quality of published reports of randomized studies on reproductive surgery. This may be linked to the CONSORT statement. The pros and cons of evidence-based practice in reproductive surgery are discussed at the end of this doctoral thesis.