Outcome of Laparoscopy in Infertile Couples attending a Teaching Hospital in Eastern Nepal: A Descriptive Cross-sectional Study

Background: Unexplained infertility is usually a diagnosis of exclusion. Thus, there must be an absence of an identifiable cause of infertility despite thorough testing and medical investigation demonstrating tubal patency, normal semen parameters, regular ovulation, normal ovarian reserve, and a normal endometrial cavity. Aim: This study aims to assess the prevalence of abnormal tubo-ovarian relationship in women with unexplained infertility by using laparoscopy. Methodology: This was a prospective study which was conducted on 30 couples with unexplained infertility. Evaluation of the tubo ovarian relation with laparoscopy for patient with unexplained infertility who desire spontaneous pregnancy. The main object of the corrective procedure is to get free mobile fallopian tube along with satisfactory tubo-ovaian relation. Results: There were 53.3% of cases had disturbed tubo-ovarian relation, many corrective measures done by laparoscopy, such as adhesiolysis for 30% of cases, excision of cysts for 6.7% of cases, MSH for 16.6% of cases and cauterization of endometriotic patches for 16.6% of cases. In the present study a pregnancy rate of 53,3% (9/16) was seen in cases that showed disturbed tubo ovarian relation and required operative intervention higher than other cases with no detected pathology (4/14) 47.7%. We were able to achieve a higher conception rate among cases owing to operative procedure. Conclusions: The ovum pick up by the fimbrial end of the tube is an essential determining factor for female infertility. The present study confirmed that laparoscopy provided a precise diagnosis of tubo ovarian factor and may switch the initial treatment of unexplained infertility.

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“…Also similar to the study of Pantou et al [27] who showed (23.3%) were diagnosed with periadnexal and pelvic adhesions.…”

Section: Detectedsupporting

confidence: 90%

Laparoscopic Assessment of the Tubo Ovarian Relationship in Unexplained Infertility

Hadwa

Farahat

Dawood

et al. 2022

JAMMR

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“…9 But such pathology was seen in 50% of cases in different forms. 24 Arojoki et al observed that the prevalence of abnormal thyroid stimulating hormone (TSH) among the subfertile couples was highest in the ovulatory dysfunction (6.3%) and unexplained subfertility (4.8%) groups and lowest in the tubal subfertility (2.6%) and male subfertility (1.5%) groups. 25 7,14,11 Only male factor contributed in approximately 16 (11.4%) cases of this study.…”

Section: Multiple Aetiological Factors Have Been Identifiedmentioning

confidence: 99%

Study on probable aetiological factors of subfertility in a tertiary care hospital

Lamsal

Tamrakar

2022

J. Kathmandu Med. Coll.

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Background: Subfertility refers to describe women or couple who are not sterile but exhibit decreased reproductive efficiency even after 12 months of regular unprotected intercourse. Objectives: To find probable aetiological factors in subfertile couples attending Dhulikhel Hospital. Methods: This descriptive cross-sectional study was conducted among 140 subfertile couples in Dhulikhel Hospital from March 2016 to December 2017 after ethical clearance. The participants were recruited by convenience sampling, data were entered in Microsoft Excel Sheet and analysed using SPSS v.23. Descriptive statistics like frequency, percent, mean, and standard deviation have been presented. Results: Among 140 subfertile couples, mean duration of subfertility was 5.55 ± 3.96 years. About two-thirds (95, 67.9%) of them were of primary subfertility. Most subfertile clients (both) were of 26-30 years age group and about three-fifths (83, 59.3%) were of Janajati caste. The most common cause of subfertility was female factor (72, 51.4%) only. Ovulatory dysfunction (49, 35%) followed by tubal abnormalities (24, 17.1%) were major female contributory factors. Thyroid disorder was noted in 19 (13.6%) clients and hyperprolactinaemia was observed in 14 (10%) subfertile female clients. Two (1.4%) female clients had diabetes mellitus and 24 (17.1%) had evidence of different forms of genital infection. Only male factor contributed was seen in 16 (11.4%) clients and asthenozoopermia was the commonest abnormal semen parameters. Six (4.3%) males with abnormal semen parameter were working abroad. Conclusion: Ovulatory causes was found to be the commonest cause of subfertility in Dhulikhel Hospital. Asthenooospermia was the most common male factor.

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Factors associated with pharmacologic serum concentration of Magnesium and corresponding obstetric outcomes among women with severe pre-eclampsia at Iringa Regional Referral Hospital

Kileo,

matovelo,

Kitinusa

2024

Preprint

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Severe pre-eclampsia is managed by using Magnesium sulphate to prevent its progress into eclampsia with a success rate of more than 50%. This study aimed at establishing reliable data pertaining factors influencing pharmacologic serum concentration of Magnesium and their correlation to obstetric outcomes. This study was carried out at Iringa regional referral hospital, spanning six months from November 2023 to April 2024. A convenient sampling technique was used to recruit 121 pre-eclamptic patients. Recruited women were tested serum Magnesium at admission, 4 and 12 hours post initial administration of MgSO4. IBM SPSS version 29 was used for analysis where, Continuous variables were analyzed by using median and interquartile range while categorical variables were analyzed using frequency and percentages. The associations between variables were determined using chi-square tests, univariate, and multivariate binary regression models. A p value<0.05 was considered statistically significant. Results: The median age of participants were (29±10 IQR), the median serum Mg at admission was (0.8±0.29 IQR) Mmol/L majority with low 53(43.8%) levels. Proportion of subtherapeutic serum Mg was 38.8% with median of (1.9±1.02 IQR) Mmol/L. Multivariate regression showed that; low serum Mg at admission [p<0.001, OR= 9.17, 95% CI (3.07- 27.37)], Creatinine level [p = 0.012, OR= 4.49, 95% CI (1.38- 14.6)], Overweight [p= 0.002, OR= 5.52, 95% CI (1.83- 16.68)] and proteinuria +++[p-value = 0.004, OR= 7.13, 95% CI (1.84- 26.86)] were significantly associated with subtherapeutic level. After adjusting with other factors, it was found that subtherapeutic level [p<0.001, OR=25.44(5.73-112.90)], elevated creatinine [p=0.040, OR=3.59(1.66-12.15)], Reduced urine output [p=0.001, OR=6.69(2.15-20.90)] were significant predictors of adverse maternal outcomes. Conclusion: Subtherapeutic serum Magnesium which significantly predict adverse obstetric outcomes, is influenced by factors which can be monitored and be useful in effective management of severe pre-eclampsia. This can help in administering tailored dose of MgSO4 for better outcomes.

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Outcome of Laparoscopy in Infertile Couples attending a Teaching Hospital in Eastern Nepal: A Descriptive Cross-sectional Study

Cited by 4 publications

References 18 publications

Laparoscopic Assessment of the Tubo Ovarian Relationship in Unexplained Infertility

Laparoscopic Assessment of the Tubo Ovarian Relationship in Unexplained Infertility

Study on probable aetiological factors of subfertility in a tertiary care hospital

Factors associated with pharmacologic serum concentration of Magnesium and corresponding obstetric outcomes among women with severe pre-eclampsia at Iringa Regional Referral Hospital

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