The Role of Diagnostic Laparoscopy in the Unexplained Infertility Cases

Ibrahim Arafa I. Hamed, Nahla W. Shady, A. Ait‐Allah
In: Journal of Scientific Research in Medical and Biological Sciences · 2021 · vol. 2(4) , pp. 57–63 · doi:10.47631/jsrmbs.v2i4.355 · W3213900839
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

Diagnostic laparoscopy identified pelvic pathologies like endometriosis, adhesions, and tubal issues in 60% of women with unexplained infertility where other investigations were inconclusive.

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This cross-sectional observational study evaluated the diagnostic value of diagnostic laparoscopy in 50 women with unexplained infertility of 1–2 years, including normal semen analysis, normal ovulation and hormonal profile, and a normal hysterosalpingogram, based on pelvic inspection for a range of pathologies. The study found that laparoscopy identified abnormal pelvic conditions in 60% of participants, including endometriosis, adhesions, and tubal pathologies, while 40% had no abnormalities detected. The major limitation is that the paper does not specify any comparison group or long-term follow-up outcomes beyond identifying pathologies. Relevance to endometriosis: endometriosis was one of the abnormal findings laparoscopy uncovered in this “unexplained infertility” population, though the paper’s main focus is diagnostic laparoscopy’s role in infertility rather than endometriosis specifically.

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Abstract

Purpose: The study examines how useful laparoscopy is in finalizing the diagnosis of unexplained infertility. Materials: The study included 50 women with 1 year or 2 years of infertility, who had a regular marital life with unprotected intercourse for more than a year, normal husband's semen analysis, normal ovulation by folliculometry, normal hormonal profile, and normal hysterosalpingogram at the department of Obstetrics and Gynecology at Aswan University Hospital from January to December 2019. Methods: This is a cross-sectional observational study involving 50 women who underwent diagnostic laparoscopy after investigations and imaging failed to reveal the cause of infertility. During the procedure, the pelvis was inspected for any pathology, including the uterus, fallopian tubes, round ligaments, ureterovesical pouch, uterosacral ligaments, Douglas pouch, and ovarian fossae. Results: Diagnostic laparoscopy helped uncover abnormal pathologies such as endometriosis, adhesions, and tubal pathologies in 30 women (60%) of the 50 included in the study, whereas no abnormality was detected in the remaining 20 (40%). Conclusion: Laparoscopy is not only a crucial diagnostic technique in infertility patients, but it can also help with treatment selections. Conducting laparoscopy in cases of unexplained infertility is linked to both peritubular adhesions and pelvic endometriosis. These pelvic disorders might not be appropriately detected or treated without laparoscopy, and hysterosalpingography and basic imaging such as pelvic ultrasonography are frequently ignored.
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Abstract

Purpose: The study examines how useful laparoscopy is in finalizing the diagnosis of unexplained infertility.

Materials

The study included 50 women with 1 year or 2 years of infertility, who had a regular marital life with unprotected intercourse for more than a year, normal husband's semen analysis, normal ovulation by folliculometry, normal hormonal profile, and normal hysterosalpingogram at the department of Obstetrics and Gynecology at Aswan University Hospital from January to December 2019.

Methods

This is a cross-sectional observational study involving 50 women who underwent diagnostic laparoscopy after investigations and imaging failed to reveal the cause of infertility. During the procedure, the pelvis was inspected for any pathology, including the uterus, fallopian tubes, round ligaments, ureterovesical pouch, uterosacral ligaments, Douglas pouch, and ovarian fossae.

Results

Diagnostic laparoscopy helped uncover abnormal pathologies such as endometriosis, adhesions, and tubal pathologies in 30 women (60%) of the 50 included in the study, whereas no abnormality was detected in the remaining 20 (40%).

Conclusion

Laparoscopy is not only a crucial diagnostic technique in infertility patients, but it can also help with treatment selections. Conducting laparoscopy in cases of unexplained infertility is linked to both peritubular adhesions and pelvic endometriosis. These pelvic disorders might not be appropriately detected or treated without laparoscopy, and hysterosalpingography and basic imaging such as pelvic ultrasonography are frequently ignored. Article Details This work is licensed under a Creative Commons Attribution 4.0 International License.

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