Laparoscopy as a diagnostic tool in evaluation of female factors in infertility

Abstract

Background: Infertility leads to considerable personal suffering and disruption of family life. According to United Nations "Reproductive health is a state of complete physical mental and social well-being and not merely the absence of disease or infirmity in all matters relating to the reproductive system and to its functions and processes". The objective of present study was to find out different causes of female infertility with diagnostic laparoscopy and their comparative frequency in primary and secondary infertility.Methods: It is a prospective study conducted on all infertile women and they underwent diagnostic laparoscopy for primary and secondary infertility during the study period. Couples who had not lived together for at least 12 months, and those with male factor infertility were excluded. Data were collected on a proforma, and analyzed on SPSS package for windows version 10. Frequencies were calculated for laparoscopic findings regarding primary and secondary infertility.Results: Fifty infertile women underwent laparoscopy during the study period, 35 (70%) had primary infertility while 15 (30%) secondary infertility. 10 (28.5%) patients with primary and 3 (20%) patients with secondary infertility had no visible abnormality. The common finding was tubal blockage in 10 (28.5%) and 5 (33.3%) cases of primary and secondary infertility respectively. 9 (25.7%) cases of primary infertility were detected as polycystic ovaries (PCO) and 2 (13.3%) in cases of secondary infertility. Endometriosis was found in 1 case with primary infertility and 2 (13.3%) cases with secondary infertility. Fibroid was found in 3 (8.57%) and 1 (6.6%) cases of primary and secondary infertility respectively.Conclusions: Most common causes responsible for infertility were tubal occlusion and polycystic ovary. Infertile couple should be thoroughly investigated. Laparoscopy in infertility can be used for a definitive diagnosis.

Correlation of ultrasonography, hysterosalpingography and hystero-laparoscopy findings in cases of infertility

“…Various studies like that of Shetty et al and Krishna C et al have shown that there is rise in age at which women present with infertility. 4,6 In present study, 3 (3.7%) patients of primary infertility and 6 (26.1%) of secondary infertility were of age >30 years. Because of the decline in fertility and the increased time to conception that occurs after the age of 30, women >30 years of age should be referred for infertility work-up after 6 months of trying to conceive.…”

Laparoscopic Evaluation of Primary and Secondary Subfertility

“…Laparoscopy is a mandatory procedure for full assessment of the infertile couple 1 It is widely accepted that infertility is a common medical problem. The role of laparoscopy in the diagnosis of primary and secondary infertility is established beyond any doubt 2 .…”

“…Diagnostic laparoscopy is generally not a part of initial infertility evaluation; however, number of reports have shown that it is effective procedure for evaluation of long term infertility 1 .…”

“…Laparoscopy provides information regarding tubal and ovarian status, uterine normality and standard means of diagnosing various pelvic pathologies eg: Pelvic inflammatory Disease, Endometriosis, Pelvic congestion and tuberculosis 1 Besides this it is the most useful method of assessment of tubal patency 1 . An accurate diagnosis is the key to successful treatment 1 .…”

“…After normal hysterosalphingography, laparoscopy reveals abnormal findings in 21.68% cases of infertile couples. Untreated pelvic inflammatory disease, postabortal, postpartum infection and tuberculosis are common factors of infertility in developing countries 1 .…”