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The Study of Laparoscopic Finding in Infertility Cases

Shruti Choudhary , Sangeeta Sen1 , Shruti Choudhary2 , Rekha Garasiya3

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Indian Journal of Obstetrics and Gynecology 7(3 ):p 385-394, July-September 2019. | DOI: http://dx.doi.org/10.21088/ijog.2321.1636.7319.6

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Sangeeta Sen, Shruti Choudhary, Rekha Garasiya. The Study of Laparoscopic Finding in Infertility Cases. Indian J Obstet Gynecol. 2019;7(3):385–394.

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Abstract

Introduction: One of the most important and under appreciated reproductive health problems in developing countries is the high rate of infertility and childlessness. The inability to procreate is frequently considered a personal tragedy and a curse for the couple, impacting on the entire family and even the local community. Negative psychosocial consequences of childlessness are common and often severe. About 20% of all patients diagnosed with polycystic ovarian syndrome (PCOS) and infertility, will not ovulate after ovulation induction treatment with clomiphene citrate. Even today, the effective treatment of clomiphene resistant PCOS remains a challenge for the medical profession. Aim & Objective: Study of laparoscopic evaluation in infertility cases at Panna Dhai Mahila Chikitsalaya, Udaipur. Material and Methods: Total 100 cases randomly selected attending OBG OPD with both primary and secondary infertility were studied. After taking detailed history, thorough clinical examination, investigations and informed consent diagnostic laparoscopy was done between 7th to 11th day of menses under GA. Patient was discharged on the 2th postoperative day according to her general condition and was followed on 5th postoperative day for stitches removal. Results: 62 cases were primary infertility and 38 cases were of secondary infertility. Pelvic ultrasonography was normal in 54 women. 77% of the women reproductive pathology was noted on laparoscopy. 23% women had normal study. In 25% of the women reproductive pathology was freshly detected by laparoscopy, which was missed by other modalities like clinical examination and ultrasound. 20 women conceived during the period of study. Among these 13 (22.14%) women had undergone concurrent therapeutic interventions at laparoscopy conceived during follow-up. 8 conceived spontaneously, 4 women who had polycystic ovaries had undergone ovarian drilling conceived after ovulation induction. One woman conceived with GnRH agonist. 6 women conceived with ovulation induction in subsequent cycles and one woman with unilateral tubal block conceived after hydrotubation in subsequent cycles. Conclusion: Most effective treatment decisions and interventions can be made in the light of laparoscopic findings in managing infertility. Though laparoscopy is invasive the complications associated with the procedure can be minimized with proper training.

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Cite this article

Sangeeta Sen, Shruti Choudhary, Rekha Garasiya. The Study of Laparoscopic Finding in Infertility Cases. Indian J Obstet Gynecol. 2019;7(3):385–394.

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DOI: http://dx.doi.org/10.21088/ijog.2321.1636.7319.6

Keywords

Laparoscopy; Infertility; PCOS.

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