Diagnostic laparoscopy in the evaluation of female factor infertility

Ashok Kumar K, Priyanka Jogi Y., Bharathi Anjanappa
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2017 · vol. 6(2) , pp. 383 · doi:10.18203/2320-1770.ijrcog20170008 · W2563491605
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study evaluated 50 infertile women via diagnostic laparoscopy, finding tubal factor infertility in 28%, endometriosis in 22%, and ovarian factors in 20% of cases.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 · read from full text ⓘ

This prospective study evaluated causes of female-factor infertility by performing diagnostic laparoscopy in 50 infertile women (41 primary, 9 secondary) after clinical and biochemical assessments, with procedures done in the premenstrual phase (days 7–9). Abnormal laparoscopic findings were observed in 82% of participants, with tubal factor (28%), endometriosis (22%), ovarian factor (20%), pelvic adhesions (8%), and fibroid uterus (4%) identified as specific causes. The authors conclude that tubal factor was the most common cause and that laparoscopy had better diagnostic value than ultrasonography for endometriosis and pelvic adhesions, while the main stated limitation is the small, single-center sample size. This paper is centrally about endometriosis — it reports endometriosis as the second most common laparoscopic cause of female-factor infertility.

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Abstract

Background: Infertility is a global problem, with more than 70 million couples suffering every year. In India 10-15% of populations are suffering from infertility. All these people need accurate diagnosis and treatment. Among the many investigations available to evaluate the female partner of the infertile couples, laparoscopy is relatively recent and considered gold standard for pelvis evaluation. The objective of the study was to study the different causes of female factor infertility with diagnostic laparoscopy.Methods: This is a prospective study done on 50 infertile females who attended infertility clinic of department of OBG, ESIC MC and PGIMSR, Rajajinagar, Bengaluru from September 2013 to 2015. Both primary and secondary infertility females were included in this study. These patients underwent diagnostic laparoscopy in premenstrual phase (7, 8, 9th day of menstrual cycle) after conducting thorough clinical and biochemical examinations.Results: In the present study total 50 infertility cases were included. 41 cases had primary infertility and 9 cases had secondary infertility. Mean age was 29.88 years and mean duration of infertility was 5.9 years. Abnormal laparoscopic findings were detected in 41 (82%) cases. Tubal factor was seen in 14 (28%) cases, 11 (22%) cases had endometriosis, 10 (20%) cases had ovarian factor, 4 (8%) cases had pelvic adhesions and 2(4%) had fibroid uterus.Conclusions: Tubal factor is the commonest cause for infertility followed by endometriosis and ovarian factor. Diagnostic laparoscopy is the gold standard procedure to assess tubal status. Laparoscopy has a better role than ultrasonography in diagnosing endometriosis and pelvic adhesions.
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Background

Infertility is a global problem, with more than 70 million couples suffering every year. In India 10-15% of populations are suffering from infertility. All these people need accurate diagnosis and treatment. Among the many investigations available to evaluate the female partner of the infertile couples, laparoscopy is relatively recent and considered gold standard for pelvis evaluation. The objective of the study was to study the different causes of female factor infertility with diagnostic laparoscopy.

Methods

This is a prospective study done on 50 infertile females who attended infertility clinic of department of OBG, ESIC MC and PGIMSR, Rajajinagar, Bengaluru from September 2013 to 2015. Both primary and secondary infertility females were included in this study. These patients underwent diagnostic laparoscopy in premenstrual phase (7, 8, 9th day of menstrual cycle) after conducting thorough clinical and biochemical examinations.

Results

In the present study total 50 infertility cases were included. 41 cases had primary infertility and 9 cases had secondary infertility. Mean age was 29.88 years and mean duration of infertility was 5.9 years. Abnormal laparoscopic findings were detected in 41 (82%) cases. Tubal factor was seen in 14 (28%) cases, 11 (22%) cases had endometriosis, 10 (20%) cases had ovarian factor, 4 (8%) cases had pelvic adhesions and 2(4%) had fibroid uterus.

Conclusions

Tubal factor is the commonest cause for infertility followed by endometriosis and ovarian factor. Diagnostic laparoscopy is the gold standard procedure to assess tubal status. Laparoscopy has a better role than ultrasonography in diagnosing endometriosis and pelvic adhesions. Metrics

References

Speroff L, Glass RH, Kase NG Clinical Gynecologic Endocrinology and Infertility 8th edn. 2011:1137-90. Omelet W, Cook I, Dyer S, Devroey P. Infertility and the provision of infertility medical services in developing countries. Hum Reprod Update. 2008;14:605-21. Mehmood S. An audit of diagnostic laparoscopies for infertility. J Sur Pak. 2003;8:8. Jayakrishnan K, Koshy AK, Raju R. Role of Laprohysteroscopy in women with normal pelvic imaging and failed ovulation stimulation with intrauterine insemination. J Hum Reprod Sci. 2010;3:20-4. Bonneau C, Chandelles O, Sifer C, Poncelet C. Use of laparoscopy in unexplained infertility. Eur J Obstet Reprodu Biol. 2012;163:57-61. Naz T, Hassan L. Laparoscopic evaluation in infertility. JCPSP. 2009;19:704. Tsuji I, Ami K, Miyazaki A, Hujinami N, Hoshiai H. Benefit of diagnostic laparoscopy for patients with unexplained infertility and normal hysterosalpingography findings. Tohoku J Exp Med. 2009;219:39-42. Mushtaq R, Mushtaq M, Iqbal S. Outcome of Laparoscopies for subfertility in military and combined Military Hospitals Rawalpindi. JSOGP. 2012;2:30-6. Aziz N. Laparoscopic evaluation of female factors in infertility. J Coll Physicians Surg Pak. 2010;20(10):649-52. Agarwal M, Anand NI. Laparoscopy in infertility. Int J Biol Med Res. 2014;5:3865-8. Goynumer G , Yetim G, Gokcen O, Karaaslan I, Wetherilt L, Durukan B. Hysterosalpingography, Laparoscopy or Both in the Diagnosis of Tubal Disease in Infertility. World Journal of Laparoscopic Surgery. 2008;1:23-6. Duraker R, Demer B, Dibaz B, Akkurt O, Kocale M. Comparisons of hysterosalpingography and laparoscopy results in the diagnosis of tubal occlusion. J Turk Soc Obstet Gynecol. 2011:8:40-3. Chimote A, Saml S, Hariharan C, Agnik R. Laparoscopy and hysteroscopy in patients of infertility in a rural set up. Int J Reprod Contracept Obstet Gynecol. 2015;4:322-8. Mboudou ET, Foumane P, Morfaw FL, Minkande JZ, Dohbit JS. Female infertility and laparoscopic surgery: A series of 415 operations at the Yaounde Gyneco-Obstetric and Pediatric Hospital, Cameroon. OJOG. 2013;3:663-7. Chakraborti DK, Jole SK. Diagnostic laparoscopy in gynecologic disorders. J Obst Gynaecol. 1990;40:262-5.

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