Introduction: Infertility can be defined as failure to conceive despite unprotected sexual intercourse for 1 year regardless of the cause of such a failure. The infertility may be caused due to male or female factors. In some instances, both male and female factors may be responsible. In approximately 15% cases no responsible factor can be identified despite extensive investigations and such infertility is then labelled as “unexplained infertility”. Role of diagnostic laparoscopy in evaluation of infertility is important in diagnosis of uterine, tubular and peritoneal causes of infertility.

Materials and Methods: This was a prospective study of women attending the infertility center of our tertiary care obstetric hospital situated in an urban area. Total 60 women with infertility were included in this study on the basis of a predefined inclusion and exclusion criteria. A detailed history, Clinical examination, per speculum and per vaginal examination was done in all the cases. Investigations such as ultrasound and hysterosalpingography was also done. Laparoscopic evaluation was done in 22 (36.67%) selected patients. Data was analyzed using Minitab 17 version. For statistical purpose P value less than 0.005 was taken as significant.

Results: Mean Age of the studied cases was found to be 29.38+/- 4.49 years. Primary and secondary infertility was seen in 71.67%and 28.33% patients respectively. 20 patients (33.33%) had menstrual irregularities in addition to infertility, while chronic abdominal pain and vaginal discharge was present in 4 (6.66%). 4 (6.66%) patients had dyspareunia in addition to infertility.  Out of the 22 (36.67%) cases in whom laparoscopy was done the most common cause of infertility was found to be endometriosis which was seen in 12 (20%) cases. Peritubal blockages, hydrosalpinx and other tubal abnormalities were found in 8 (13.33%) cases. In remaining 2 (3.33%) patients no abnormality was detected on laparoscopy.

Conclusion: Laparoscopic evaluation of the women presenting with primary as well as secondary infertility may be helpful in identifying uterine, peritubal and peritoneal causes of infertility and should be done before labelling the infertility to be “unexplained”.

Keywords: Infertility, evaluation, Diagnostic laparoscopy, Endometriosis.

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Chetana A Gopchade

Consultant Obstetrician and Gynecologist, Amrutpath Maternity and Children’s Hospital Nanded (MS)- India