As embryoscopy and endoscopic technique and instruments evolve, medical professionals will be able to monitor the embryo at earlier and earlier stages, thus allowing for timely diagnosis.   One of the exciting embryofetoscopy prospects will eventually be able to utilize gene and cell therapy for therapeutic intervention once the embryo becomes immunologically tolerant or naïve and more receptive to grafts [2].  Using gene probes for DNA analyses, early prenatal diagnosis of genetic diseases and consequent treatment of currently incurable diseases that cause irreversible damage by the birth time will soon be available.  Tissue samples like those from bone marrow could be used effectively for gene or cell transfer and embryofetoscopy is a suitable procedure for intravascular transfusion at early developmental stages [6].  Some preliminary studies on sheep for transfer of β–galactosidase marker gene to the lungs indicated that gene transfer to the late gestation fetus for treatment of congenital pulmonary disease may be feasible through embryofetoscopy [2]. 

Moreover, embryofetoscopy will allow for surgery in utero on the placenta, membranes and fetus itself [3].  Early studies have been reported where successful umbilical cord ligation of an acardiac twin and percutaneous fetal cystoscopy were performed.  Furthermore, combination of embryofetoscopy and video-endoscopic surgery further impoves in utero surgical procedures.  Higher survival rates and lower rates of postoperative pulmonary complications have been reported in embryofetoscopy patients as compared to hysterotomy patients [2].  Treatment of abnormal monochorionic twin gestations was also benefited by this technique.  Fetoscopic laser coagulation of chorionic plate vessels can be used to treat feto-fetal transfusion syndrome, which complicates 10 to 15% monochorionic multiple pregnancies [3].   Via ablation of placental vascular connections, shared circulation is interrupted.  A 400 to 600um Nd:YAG laser can be employed for this purpose and inserted through the operative sheath and laser occlusion performed based on vessels’ fetoscopic appearance [3].  Lysis of amniotic bands can also be performed using embryofetoscopy, as well as treatment of congenital diaphragmatic hernia, cystic adenomatoid malformation of the lung, sacrococcygeal teratoma and lower urinary tract obstruction, provided preterm pregnancy termination does not occur, which is one of the larger risks (10%-12%) in these procedures [3].  Future research should also be targeted at developing techniques for sealing the defects more reliably.  Methods such as intraamniotic injection of platelets and cryoprecipitate are promising new venues as well as collagen plugs for sealing access sites [3].  

Embryofetoscopy is still considered an invasive method, thus risks and benefits must be weighted carefully as miscarriage in normal pregnancies can often occur due to this procedure.  So far, embryofetoscopy is most beneficial and safe in missed abortions as there is no risk of miscarriage and much can be learned from failed embryonic developmental stages [1].  In the future, as embryofetoscopy becomes a more reliable method, it could be more widely employed in  healthy pregnancies and at earlier stages  as necessary.