The Role of Laparoscopy in the Management of Infertility Patients: A Cross Sectional Study

Abstract Background and Objectives: Infertility affects 10 – 15 % of couples is an important part of clinical practice for many clinicians. Laparoscopy is an important tool to assess the reproductive pathology including tubal patency in infertile women. In the same setting therapeutic intervention can be done. Objectives of the study: To determine the definitive reproductive pathology using laparoscopy to provide the basis for treatment of infertility patients. To appraise the evidence on the effectiveness of laparoscopy in the treatment of female infertility. Methods: This is a crossectional study conducted on 95 women with primary infertility from 1/08/14 to 1/08/15 . Infertility work up included semen analysis, Ultrasonography, TSH, LH,FSH, serum prolactin. Women were subjected to laparoscopy under GA. Laparoscopic findings were noted and therapeutic interventions were done if required . Intra operative and post operative complications were noted. Result: The mean age of women in the study was 28.6 yrs.The mean duration of infertility was 5.2 yrs. In 87.4% of the women pelvic pathology was noted on laparoscopy. Among these 33.6% of the women had undiagnosed pathology detected on laparoscopy. The pathology detected was polycystic ovaries (35.7%),tubal pathology(17.8%), tubal block(11.5%),pelvic adhesions(22.1%) endometriosis(15.7%). Therapeutic intervention was done in 75.7% of the women. There was difficulty in creating pneumoperitoneum in 2 women. None of the women had intraoperative or post operative complications.20 women conceived during the period of study. Conclusion: Ovulatory infertility(43%) and tubal infertility and adhesions (22%) are common causes of infertiliy. Laparoscopy is a valuable technique for the complete assessment of female infertilityand has successfully shortened the duration of infertility and increased the conception rate in my study. Hence laparoscopy can be used as a gold standard in the diagnosis and management of infertility particularly among the women whose 1. Age > 30 YRS 2. Duration of infertility > 5 yrs 3. PCODS patients who are Gnrh resistant and high serum LH 4. Unexplained female infertility and should be used early in the diagnostic work up Keywords: Infertility, Laparoscopy.