[Laparoscopy/laparotomy evaluation of artificial donor insemination failures].

The cases of 24 women who failed to conceive after 6 months of donor artificial insemination (AID) are reviewed. Preliminary examination before AID including endometrial biopsy and hysterosalpingography revealed no discernible cause for infertility. When conception had not occurred by the 6th treatment cycle the patients were reevaluated for a tuboperitoneal cause of infertility. Laparoscopy was used in 4 cases laparoscopy and laparotomy in 4 cases and laparotomy alone in 16 cases. 15 of the 24 women (62.5%) were found to have pelvic factors potentially detrimental to fertility. Uterine fibroids were the most common disorder (6 cases) followed by pelvic endometriosis (5 cases) and pelvic inflammatory disease (5 cases). Surgical correction including myomectomy uterotubal implantation and fertility laparotomy was attempted in these women. Following surgery AID was resumed. Although follow-up data are not complete 4 pregnancies are known to have occurred. These results confirm the value of discontinuing AID after the 6th failed cycle and reevaluating fertility potential through laparoscopic examination.