Laparoscopic evaluation in infertility.

OBJECTIVE To describe the different causes of infertility based on findings of diagnostic laparoscopy and their comparative frequency in primary and secondary infertility. STUDY DESIGN A cross-sectional study. PLACE AND DURATION OF STUDY Obstetrics and Gynaecology Unit of Hayatabad Medical Complex, Peshawar, from January to December 2005. METHODOLOGY All patients undergoing diagnostic laparoscopy for primary or secondary infertility were included. Male factor infertility cases was excluded. Frequency of the causes and finding was determined. RESULTS One hundred and thirty six (70.46%) patients with primary and 57 (29.54%) with secondary infertility underwent diagnostic laparoscopy. Seventy (51.47%) with primary and 26 (45.51%) with secondary infertility had no visible abnormality. Bilateral tubal blockage was found in 32 (23.53%) primary and 16 (28.07%) cases of secondary infertility. Dense pelvic adhesions forming adnexal mass were found in 9 (6.61%) and 6 (10.5%) of primary and secondary respectively. Two cases each of bicornuate uterus and double uterus in primary infertility patients. Ovarian pathology was found in 18 (13.23%) primary and 4 (7.01%) cases of secondary infertility. PCO (polycystic ovaries) were detected in 12 (8.82%) and 2 (3.5%) cases of primary and secondary infertility respectively. Endometriotic cysts and deposits were found in 15 (10.29%) cases of primary and 3 (5.26%) cases of secondary infertility. CONCLUSION Tubal disease is a common factor responsible for infertility and diagnostic laparoscopy is a valuable technique for complete assessment of female infertility and making treatment decisions according to the cause.