Diagnostic Laparoscopy in the Evaluation of Female Factors in Infertility in Kashmir Valley

Abstract

Objectives: To evaluate the female factors in infertility using laparoscopy in Kashmiri women. Materials and Methods: One hundred cases of infertility [primary and secondary] were included in this prospective study. Before the procedure, apart from complete history and detailed examination, baseline investigations (complete blood count, blood sugar, kidney and liver function tests, ECG, chest X-ray) were performed as per our institutional protocol for pre-anaesthesia check up. Laparoscopy was done in proliferative phase of menstrual cycle. To test the patency of tubes, chromotubation was done in all cases under laparoscopic vision by using 10-15 ml of autoclaved methylene blue dye. All the data was collected on pre-designed proforma and the results were tabulated and raw percentages calculated to describe the results. Results: In primary infertility group [n=82], most common laparoscopic finding was tubal occlusion in 15 (18.3%), followed by endometriotic deposits in 14 (17.1%) patients. Other findings were polycystic ovaries in 10 patients (12.2%), peritubal and periovarian adhesions in 6 patients (7.3%), fibroids in 6 patients (7.3%), genital tract tuberculosis in 5 patients (6.1%), ovarian cysts in 4 patients (4.8%), hypoplastic uterus in 2 patients (2.4%) and pelvic inflammatory diseases in 2 patients (2.4%), in this group. The commonest finding by laparoscopy in patients with secondary infertility [n=18] was tubal occlusion in 5 (27.7%), followed by peritubal and periovarian adhesions in 4 (22.2%) patients. Conclusion: laparoscopy is very effective and cheap method in evaluating infertile women and should be considered earlier in infertility workup for effective and early treatment decisions. 1Senior Resident department of obstetrics and gynecology, Sheri Kashmir Institute of Medical Sciences Medical College, Srinagar, J&K, India. 2Associate Professor department of obstetrics and gynecology, Sheri Kashmir Institute of Medical Sciences Medical College, Srinagar, J&K,India. 3Senior Resident department Of General and Minimal Access Surgery, Sheri Kashmir Institute of Medical Sciences Srinagar, J&K, India. 4Assistant Professor department of obstetrics and gynaecology, Sheri Kashmir Institute of Medical Sciences Medical College, Srinagar, J&K, India. Article History: Received 10 October 2013 Accepted 7 January 2014 Revised 25 December 2013 Available online 7 January 2014