Evaluation of role of laparoscopy in determining etiology of infertility


  • Hema K. R. Department of Obstetrics and Gynecology, Sree Sidhartha Medical College, Tumkur, Karnataka, India
  • Lalitha H. S. Department of Obstetrics and Gynecology, Sree Sidhartha Medical College, Tumkur, Karnataka, India




Diagnostic laparoscopy, Primary infertility, Secondary infertility, Tubal factors, Uterine factors


Background: Although population explosion is a major problem in India, infertility appears to be a problem in 5-15% of Indian population. All these patients require evaluation. Laparoscopy plays a valuable role in the diagnosis of infertility. After thorough clinical examination and specific investigations, diagnostic laparoscopy is performed to detect patency of tubes, morphological defects in uterus, ovaries and tuboperitoineal factors. This study was conducted to assess the role of diagnostic laparoscopy in the investigation of female infertility and to evaluate the various causes of infertility like endometriosis, PCOD tubal and peritoneal factors, uterine anomalies, tuberculosis etc. by using diagnostic laparoscopy.

Methods: Study was carried out in 60 infertile patients attending outpatient department of hospitals attached to Sri Siddhartha Medical College Hospital, Tumkur.  Both primary and secondary infertility patients who were anxious to conceive and undergo diagnostic laparoscopy were evaluated. Those who were not willing and who were contraindicated for the procedure were excluded.

Results: Diagnostic laparoscopy was performed in 72% of primary and 28% of secondary infertility patients. Majority of the patients of primary infertility were in age group 21-25 years and that of secondary were between 26-30 years. Majority of patients in both the groups had duration of 1-5 year of infertility. In our study tubal factors (50%) contributed to majority of the infertility causes. Complication rate was minimum and was comparable to other standard studies.

Conclusions: Laparoscopic is the gold standard for diagnosing tubal and peritoneal disease, endometriosis and other pelvic pathology, because no other imaging technique gives the same degree of sensitivity or specificity. Hence diagnostic laparoscopy is an indispensable tool in the evaluation in the evaluation infertility.


Aral SO, Cates W Jr. The increasing concern with infertility, Why now? Science. 1983;250:2327.

VG Padubidri, SN Daftary, Shaw's text book of Gynaecology, 13th Ed. Reed Elsevier India Pvt Ltd; 198.

Berek JS, Rinehart RD, Hillard PA, Adashi EY. Novak's Gynaecology. 13th Ed. Lippincott Williams & Wilkins;973-974, 979, 983.

Gomel V, Taylor PJ. Diagnostic laparoscopy in infertility. Chapter 9, In diagnostic and operative gynaecologic laparoscopy. Mosby Year book Medical Publishers;1995.

Patel DN, Dalai DS. Laparoscopic equipment. Gynaecologic Endoscopy. 1986;3-20:57-61.

Templeton AA, Kerr MG. An assessment of laparoscopy as the primary investigation in the sub fertile female. Br J Obst Gynaecol. 1977;84:3564-5.

Duignan NM. One thousand consecutive cases of diagnostic Laparoscopy. J Obst Gynecol Br C Wealth. 1972;79:1016-24.

Sharma R, Sharma V. The infertile woman; a study of 120 cases. J Indian Med Asssoc, 1991;89(2):31-32.

Chakraborti DK, Kole SK. Diagnostic laparoscopy in gynaecologic disorders. J Obstet Gynecol. 1990;40:262-5.

AG Bhide. Laparoscopic evaluation of the etiopathology of infertility. J Obstet Gynecol India. 1990;40:680-2.

Sharma R, Taly A, Guleri AS. Laparoscopic evaluation of cases of primary and secondary infertility. J Obstet Gynecol India. 1997;47(4):366-71.

Chamberlain G, Brown JC. Fertility Committee of RCOG gynaecological laparoscopy. The report of the world party of the confidential enquiry into gynaecological laparoscopy. 1992:126.






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