Application of laparoscopy in current fertility practice

Authors

  • Rajita S. Jani Department of Obstetrics and Gynecology, L.G. Hospital, Maninagar, Ahmedabad, Gujarat, India
  • Devangi S. Munshi Department of Obstetrics and Gynecology, L.G. Hospital, Maninagar, Ahmedabad, Gujarat, India
  • Shashwat K. Jani Department of Obstetrics and Gynecology, V.S. General Hospital, Ellisbridge, Ahmedabad, Gujarat, India
  • Sanjay P. Munshi Department of Obstetrics and Gynecology, V.S. General Hospital, Ellisbridge, Ahmedabad, Gujarat, India

Keywords:

Laparoscopy, Infertility

Abstract

Background: The present study is carried out with the objective of establishing the role of diagnostic and operative laparoscopy as a simple, safe and accurate tool in the evaluation of infertility. The aims of current study were to study the application of laparoscopy in current fertility practice, to evaluate indications for diagnostic laparoscopy for infertility, to study findings of diagnostic laparoscopy and to study various operative procedures performed for correction of infertility.

Methods: This is a prospective study of 50 women undergoing infertility workup in a private hospital from January 2011 to January 2012. All infertile women having primary or secondary infertility were included in the study. Couples having male factor infertility were excluded from the study. Data were collected and analyzed.

Results: Our study is conducted in 50 cases of infertility patients out of which 74% were primary infertility and 26% were secondary infertility. Uterine factors were found in 16% of cases, tubal factors were found in 44% of cases, ovarian factors were implicated in 30% of cases out of which majority (12%) had PCOD. Among the peritoneal factors (18%) endometriosis and pelvic adhesions were found in 6% each. Inspite of thorough laparoscopic evaluation no cause (unexplained infertility) was found in 14% of cases and hence overall, the pelvic pathology was found in 86% of cases.

Conclusions: Laparoscopy is the gold standard for diagnosing tubal and peritoneal disease, endometriosis, adhesions and other pelvic pathology, because no other imaging technique provides the same degree of sensitivity and specificity.

References

Leon Speroff. Female infertility. In: Leon Speroff, Marc A. Fritz, eds. Clinical Gynecologic Endocrinology and Infertility. 17th ed. Philadelphia: Lippincott Williams and Wilkins; 2005: 1003-1058.

V. G. Padubidri. Pathology of Conception. In: V. G. Padubidri, S. N. Daftary, eds. Shaw: Text book of Gynecology. 14th ed. Noida: Reed Elsevier India Pvt. Ltd; 2008 : 198-199.

Gomel V, Taylor PJ. History of laparoscopy. In: Gomel V, Taylor PJ, eds. Diagnostic and Operative Gynecologic Laparoscopy. 1st ed. St. Louis: Mosby Year Book Medical Publishers; 1995 : 46-62

Coltart, T. M. Laparoscopy in the diagnosis of tubal patency. BJOG. 1970;77:69-71.

Shetty SS, ND Krishna VR. A comparative study of hysterosalpingogram vs. laparoscopy in patients with infertility. J Obstet Gynecol India. 1972;29:511-5.

Klinger BE. Evaluation, therapy and outcome in 493 infertile couples. Fertil Steril.1984;4(1):40-6.

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

Sharma R, Sharma V. The infertile woman a study of 120 cases. J Indian Med Assoc.1991;82(2):13-32.

Fertility Committee of RCOG Gynecological Laparoscopy. The report of the World party of the confidential enquiry into gynecological laparoscopy. Fertility Committee of RCOG Gynaecological Laparoscopy. 1992:126.

Bhide AG., Nalbanski B, Sirakor M, Georgiev S. Diagnostic laparoscopy in female sterility. Khirugia Softia. 2003;50(3):35-6.

Corson SL, Chen A, Gutmann JN. Laparoscopy in the normal infertile patient, a question revisired. J Am Assoc Gynecol Laparo. 2000;7(3):317-24.

Kumar P, Dang A. Is Laparoscopy necessary in all infertile patients? J Obstet Gynecol India. 2001;51(2):105-8.

Jonathan S. Berek. Operative gynecology. In: Jonathan S. Berek, R. D. Rinehart, P. A. Hillard, Eli Y. Adashi, eds. Novak’s Gynecology. 14th ed. Philadelphia: Lippincott Williams and Wilkins; 2007: 973-974, 979-983.

Tindal VR. Infertility and Subfertility. In: Tindal VR, eds. Jeffcoates Principles of Gynecology. 7th ed. Butterworth: Heinemann International ed; 2008: 699-741.

Steptoe PC. Gynecology endoscopy, culdoscopy and laparoscopy in infertility. J Obstet Gynecol Br C Wealth. 1965;72:535.

Gomel V, Taylor PJ. Diagnostic laparoscopy in infertility. In: Gomel V, Taylor PJ, eds. Diagnostic and Operative Gynecologic Laparoscopy. 1st ed. St. Louis: Mosby Year Book Medical Publishers; 1995: 466-481.

Gomel V, Taylor PJ. Indications and contraindications of diagnostic laparoscopy. In: Gomel V, Taylor PJ, eds. Diagnostic and Operative Gynaecology laparoscopy. 1st ed. St. Louis: Mosby Year Book Medical Publishers; 1995: 241-264.

Naz T, Hassan L, Gulmeen, Nighat F, Sultan S. Laparoscopic evaluation in infertility. J Coll Physicians Surg Pak. 2009 Nov;19(11):704-7.

Sakar MN, Gul T, Atay AE, Celik Y. Comparison of hysterosalpingography and laparoscopy in the evaluation of infertile women. Saudi Med J. 2008 Sep;29(9):1315-8.

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Published

2017-01-02

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Original Research Articles