Causes of Primary Versus Secondary Infertility in Women Undergoing Diagnostic Laparoscopy

Abstract Background: Infertility is defined as failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse,. This study was planned to compare the frequency of different causes of infertility undergoing diagnostic laparoscopy and chromopertubation. Objective: To compare the frequency of different causes of infertility in women with primary and secondary infertility undergoing diagnostic laparoscopy Material and Methods: This study was a five-year retrospective observational study conducted in Lady Reading Hospital from January 2017 to December 2021. Data record of all patients who underwent diagnostic laparoscopy and chromopertubation for infertility was retrieved. Basic demographic features like age, type of infertility (primary or secondary) and duration of infertility were noted in all patients. During the procedure, any abnormal features of the uterus, ovaries, and fallopian tubes including patency, uterosacral ligaments, Pouch of Douglas, and any adhesions or endometriosis were also noted. Findings were recorded on proforma.IBM SPSS Version 22.0 was used for data analysis Results: In this study, we got a record of 1945 patients, n=1427 (71.9%) patients had primary infertility while n=518 (26.1 %) had secondary infertility, mean age was 29.73± 4.37. Regarding causes of infertility, abnormal findings in fallopian tubes were more common in patients with secondary infertility (31.46% versus 23.05% of cases of primary infertility),an ovarian abnormality was observed in 16.88% in primary versus 22.58 in secondary infertility, endometriosis was seen in 27.99% of cases of secondary infertility in comparison to 22.42% in primary infertility, fibroid uterus was noted in 11.5% of primary infertility and 8.5 % of cases of secondary infertility. Conclusion: Tubal pathology and endometriosis are the most frequent abnormalities found in patients with secondary infertility, and uterine abnormalities are more common in patients with primary infertility.