Use of laparoscopy in unexplained infertility

C Bonneau, Claire Bonneau, Bonneau C, O. Chanelles, Chanelles O, Sifer C, C. Sifer, Poncelet C, C. Poncelet
European journal of obstetrics, gynecology, and reproductive biology · 2012 · vol. 163(1) , pp. 57–61 · doi:10.1016/j.ejogrb.2012.03.036 · PMID:22512828 · W2013541283
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Diagnostic laparoscopy in unexplained infertility revealed pelvic pathologies in 95 patients and led to a 77% pregnancy rate, indicating its value and the importance of tubal efficiency.

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Abstract

ObjectiveThe use of laparoscopy in unexplained infertility work-up is still a subject of debate, although laparoscopy remains the gold standard for diagnosis and treatment of several pelvic pathologies. The objective of this study was to assess the rates and types of pelvic pathologies observed during diagnostic laparoscopy, and the pregnancy rate in couples with unexplained infertility following laparoscopy.Study designProspective study, from November 2003 to October 2009, including 114 infertile, spontaneously ovulating women with normal clinical examination, ovarian reserve assessment, pelvic ultrasound scan and patent tubes on hysterosalpingography. Semen analyses were normal according to the World Health Organization criteria. After three cycles of ovulation induction with or without intra-uterine insemination and no pregnancy, women were referred for diagnostic laparoscopy.ResultsLaparoscopy revealed pelvic pathology in 95 patients. Endometriosis, pelvic adhesions and tubal disease were observed and treated in 72, 46 and 24 patients, respectively. Following laparoscopy, bilateral and unilateral tubal patencies were observed in 107 and five patients, respectively. Pregnancy was observed in 77 out of 102 patients who tried to conceive after surgery, 35 of whom conceived using their own tubes.ConclusionDiagnostic laparoscopy should be strongly considered in unexplained infertility work-up, and tubal efficiency should not be underestimated.

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Condition tags

endometriosisinfertility

MeSH descriptors

Infertility, Female Laparoscopy Adult Endometriosis Endometriosis Fallopian Tube Diseases Fallopian Tube Diseases Female Humans Infertility, Female Infertility, Female Pelvis Pelvis Pelvis Pregnancy Pregnancy Rate Prospective Studies Tissue Adhesions Ultrasonography

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