Abstract
Background: Infertility affects approximately 10% of the population.One third (30%) of infertility can be attributed to male factors, and about one third (30%) can be attributed to female factors. In about 20% of cases infertility is unexplained, and the remaining 10% of infertility is caused by a combination of problems in both partners. Diagnostic laparoscopy is the gold standard in diagnosing tubal pathology and other intra‐abdominal causes of infertility. Objective: To evaluate the role of laparoscopy in the diagnosis of infertility. Study design: Retrospective study. Setting: Department of Obstetrics and Gynaecology, K.S. Hegde Charitable hospital, Mangalore from July 2006 to December 2007. Methods: Fifty infertile women underwent diagnostic laparoscopy during the study period. Couples who had not lived together for at least 12 months, and those with male factor infertility were excluded. Laparoscopy was scheduled in the proliferative phase of the menstrual cycle. Results: Of thefifty women studied, 34 (64%) had primary infertility while 16 (36%) secondary infertility. Laparoscopy revealed normal findings in 8 (23.5%) with primary infertility and 2 (12.5%) with secondary infertility. The common finding was tubal blockage in 9 (26.5%) and 4 (25%) of primary and secondary infertility respectively. Polycystic ovaries were detected in 4 (11.7%) of primary infertility and 1 (6.25%) in secondary infertility. Endometriosis was found in 5 (14.7%) with primary infertility and 1 (6.25%) in secondary infertility group. Pelvic inflammatory disease (PID) was found in 1 (2.9%) and 3 (18.7%) of primary and secondary infertility respectively. Peritubal and periovarian adhesions were detected in 3 (8.8%) with primary infertility and 3 (18.7%) in secondary infertility. Fibroids were found in 3 (8.8%) and 1 (6.25%) in primary and secondary infertility respectively. Ovarian cyst detected in 1 (2.9%) in primary infertility and 1(6.25%) in secondary infertility. Conclusion: The most common cause responsible for infertility was tubal occlusion in both primary and secondary infertility group. Laparoscopy is necessary in establishing diagnosis of female infertility.
Highlights
Infertility is defined as failure to conceive during one year of unprotected frequent intercourse.[1]
Leadingcauses of infertility include tubal disease, ovulatory disorders, uterine or cervical factors, endometriosis and male factor infertility. 1,2,3 Major causes according to WHO on a global basis are malnutrition, pelvic tuberculosis and puerperal infections leading to tubalblockage.[4]
It has got an advantage of direct visualization of the pelvic organs and the peri-tubal status resulting in greater information as compared tohysterosalpingography and ultrasonography.[7]
Summary
Infertility is defined as failure to conceive during one year of unprotected frequent intercourse.[1]. Shetty & Shetty offers an excellent means through direct visualization to elucidate the hidden pathology It has got an advantage of direct visualization of the pelvic organs and the peri-tubal status resulting in greater information as compared tohysterosalpingography and ultrasonography.[7] Theadvance in instrument technology has made this procedure more productive and less hazardous. The objective of our study was to highlight the role of laparoscopy in establishing diagnosis of female infertility. Diagnostic laparoscopy is the gold standard in diagnosing tubal pathology and other intra‐abdominal causes of infertility. The common finding was tubal blockage in 9 (26.5%) and 4 (25%) of primary and secondary infertility respectively. Conclusion: The most common cause responsible for infertility was tubal occlusion in both primary and secondary infertility group.
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