Title: Role of Diagnostic Laparoscopy in Evaluation of Infertile Women -A Retrospective Study
Authors: Shanthi Ponnuswamy, Sasivannan Anbarasu, Iyanar Kannan
DOI: https://dx.doi.org/10.18535/jmscr/v6i5.123
Abstract
Background: The aim of the study is to detect the role of diagnostic laparoscopy in detecting uterine, ovarian and pelvic pathologies in infertile women. It should be offered to all infertility cases who have completed a basic infertility evaluation for the female and male. It provides direct visualisation of the pelvic organs and more importantly the tubal status and patency[1]. Not only does this help in identification of unsuspected pelvic pathology but also contributes to decision making of infertility treatment.
Methods: This retropective study included 60 infertile women both primary and secondary, it was conducted at department of Obstetrics and Gynaecology, Tagore medical college and hospital chennai, during the period between January 2013 to December 2017. After thorough gynecological examination, necessary investigations were made and written consent form was taken from them before laparoscopy. The patients were kept fasting for 24 hours before the laparoscopy and the procedure was performed under general anaesthesia. 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: Of sixty women studied, 41 (68%) had primary infertility while 19(32%) secondary infertility. Laparoscopy revealed normal findings in 6 (10%) with primary infertility and 3 (5%) with secondary infertility. The common finding was pelvic adhesion in 13(31%) and 8 (42%) of primary and secondary infertility respectively. Polycystic ovaries were detected in 11(26.8%) of primary infertility and 3 (15.7%) in secondary infertility. Endometriosis was found in 6(14.6%) with primary infertility and 3 (15.7%) in secondary infertility group. Fibroids were found in 4 (9.8%) and 2 (10.5%) in primary and secondary infertility respectively. Ovarian cyst detected in 5(12%) in primary infertility and 2(10.5%) in secondary infertility. Significant observation in this study was ovarian pathology commonly involved in primary infertility but tubal factors in secondary infertility.
Conclusion: Laparoscopy is safe and cost-effective method and should be considered as prime diagnostic tool for evaluating the etiology of infertility in women and for effective treatment decisions.
Keywords: Diagnostic laparoscopy, Primary infertility, Secondary infertility.