Diagnostic laparoscopy in the evaluation of tubal factor in cases of infertility (original) (raw)
Related papers
Experience with Diagnostic Laparoscopy in the Evaluation of Tubal Factor Infertility
Open Journal of Obstetrics and Gynecology, 2020
Context and Objectives: Tubal factor infertility accounts for a large portion of female factor infertility. Tubal disease is responsible for 25%-35% of female infertility. The most prevalent cause of tubal factor infertility is pelvic inflammatory disease and acute salpingitis. The incidence of tubal damage after one episode of pelvic infection is approximately 12%, 23% after two episodes and 54% after three episodes. Various modalities for investigating tubal factor infertility exist including: saline Infusion sonography (SIS), Hystero-contrast sonography (HyCoSy), hysterosalpingography (HSG) and laparoscopy with chromopertubation, the latter being the gold standard. The aim of this study was to determine the role of diagnostic laparoscopy in the evaluation of tubal factor in infertile women. Settings and Design: A retrospective descriptive study on all diagnostic laparoscopic procedures carried out to evaluate tubal factor infertility in the endoscopic gynecology unit of a tertiary-level hospital from 2010 to 2019. Methods: A retrospective descriptive study was conducted in the Department of Obstetrics and Gynaecology of a tertiary-level hospital in Ghana. A total of three hundred and ninety-one (391) records of all diagnostic laparoscopy procedures performed because of infertility in the endoscopic gynecology unit of a tertiary-level hospital between 2010 and 2019 were analyzed. Clients who underwent diagnostic laparoscopy to assess tubal factor infertility in the Obstetrics and Gynaecology Directorate of Komfo Anokye Teaching Hospital (KATH), Kumasi, from 2010 to 2019 were included in the study. Tubal patency was tested by laparoscopy and chromopertubation using methylene blue dye. The clinical characteristics of these women (age, parity, type of infertility), the intra-operative findings and complications were evaluated. Data on age, parity, type of infertility and intra operative findings were extracted using a proforma. Cases in which the bio-data or other clinical and laparoscopic findings were missing were excluded from the study.
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Approximately 15% of couple are affected by infertility. Tubal factor is one of the most frequent causes of infertility in women. As tubo-peritoneal factor is accountable for 30-40% of female infertility, evaluation of tubal patency is the basic investigation for assessment of female infertility. Hysterosalpingogram (HSG) and laparoscopy are the two most commonly conducted tests to evaluate the tubal factor of female infertility. The aim of the study was to compare hysterosalpingogram with laparoscopy in the diagnosis of tubal factor of female infertility. METHODS This is an observational cross-sectional study conducted among 80 infertile women either primary or secondary in the Department of Gynaecology and Obstetrics, R.G. Kar Medical College, Kolkata, a tertiary care hospital in NorthEast , over a period of one and half years (January 2018 to July 2019). Primary infertility incidence was 56.3% and that of secondary infertility was 43.8%. More than half the subjects (66.3%) were between 26 to 35 years of age. Mean age of the study population was 27.43 ± 5.14 years. The mean period of infertility (Mean ± S.D.) of patients was 4.3375 ± 2.3164. Both procedures were done in the same patient. HSG was done in preovulatory phase. Laparoscopy was performed under general anaesthesia. Data had been summarized as mean and standard deviation for numerical variables and count and percentages for categorical variables. RESULTS Association of spillage of dye in HSG vs. laparoscopy was statistically significant (p<0.0001). Association of tubal block in HSG vs. laparoscopy was also significant. Association of abnormal tubal architecture in HSG vs. abnormal tubal architecture in laparoscopy is statistically significant (p= 0.0111296452). Difference in uterine filling defect in HSG and fibroid in laparoscopy was statistically significant (p=0.0013005280). Laparoscopy shows presence of fibroid in more no. of cases. In diagnosis of peritubular adhesion and abnormal tubal architecture, laparoscopy was significantly better than HSG. CONCLUSIONS HSG and laparoscopy are the two classic methods for evaluation of tubal patency in infertile women and are complementary to each other. HSG is less invasive, less expensive, more informative with regard to tubal luminal architecture; whereas, laparoscopy is the gold standard for tubal assessment.
Zahedan Journal of Research in Medical Sciences
Background: The prevalence of infertility in the world is increasing, and diagnosis of the cause of infertility help to better and faster treatment. Objectives: The aim of this study was to evaluate the detection of tubal factor with hysterosalpingography (HSG) and laparoscopic methods in infertile women referred to Ali ibn-e Abitaleb Hospital. Methods: This descriptive-analytical study was performed on women referred to the infertility clinic of Ali ibn-e Abitaleb Hospital of Zahedan. All patients underwent HSG and laparoscopy on days 6 to 12 of the menstrual cycle. The data were collected using information form and then analyzed by SPSS software. Results: In this study, 142 infertile women were studied. The mean age of the patients was 30.6 ± 5.8 years old. In this study, HSG was normal and abnormal in 57.7% and 42.3% of the patients, respectively. Moreover, laparoscopy was normal and abnormal in 76.1% and 23.9% of the patients, respectively. There was a relative agreement between...
Diagnostic Laparoscopy in the Evaluation of Female Factors in Infertility in Kashmir Valley
International Journal of Women's Health and Reproduction Sciences, 2014
Objectives: To evaluate the female factors in infertility using laparoscopy in Kashmiri women. Materials and Methods: One hundred cases of infertility [primary and secondary] were included in this prospective study. Before the procedure, apart from complete history and detailed examination, baseline investigations (complete blood count, blood sugar, kidney and liver function tests, ECG, chest X-ray) were performed as per our institutional protocol for pre-anaesthesia check up. Laparoscopy was done in proliferative phase of menstrual cycle. To test the patency of tubes, chromotubation was done in all cases under laparoscopic vision by using 10-15 ml of autoclaved methylene blue dye. All the data was collected on pre-designed proforma and the results were tabulated and raw percentages calculated to describe the results. Results: In primary infertility group [n=82], most common laparoscopic finding was tubal occlusion in 15 (18.3%), followed by endometriotic deposits in 14 (17.1%) patients. Other findings were polycystic ovaries in 10 patients (12.2%), peritubal and periovarian adhesions in 6 patients (7.3%), fibroids in 6 patients (7.3%), genital tract tuberculosis in 5 patients (6.1%), ovarian cysts in 4 patients (4.8%), hypoplastic uterus in 2 patients (2.4%) and pelvic inflammatory diseases in 2 patients (2.4%), in this group. The commonest finding by laparoscopy in patients with secondary infertility [n=18] was tubal occlusion in 5 (27.7%), followed by peritubal and periovarian adhesions in 4 (22.2%) patients. Conclusion: laparoscopy is very effective and cheap method in evaluating infertile women and should be considered earlier in infertility workup for effective and early treatment decisions.
International Journal of Medical and Biomedical Studies
Objectives: Hysterosalpingography and laparoscopy both are the diagnostic methods for assessment of female infertility. The present study was to compare the evaluation of hysterosalpingography (HSG) versus laparoscopy in determination of tubal factors in female infertility. Methods: Detailed assessment, physical examination and clinical investigations were performed in all 100 infertile female with age 20 years to 40 years. All patients were advised to perform digital HSG. Patients with an abnormal HSG underwent laparoscopy without delay, whereas in patients with a normal HSG, laparoscopy was performed three months after HSG. HSG is best scheduled during the 2nd -5th day interval immediately following the end of menstruation, to minimize risk for infection, avoid interference from intrauterine blood and clot, and to prevent any possibility that the procedure might be performed after conception. Results: Data was analysed by using IBM SPSS version 23 software. All data was tabulate...
Aim: The aim of this work is to evaluate different factors affecting tubal patency in both primary and secondary infertile women using laparoscopy. Patients and methods: This study included 130 women with a diagnosis of infertility secondary to tubal factor. The patients were selected from gynecology outpatient clinic or the family planning clinic, Zagazig University Maternity Hospital. All patients had blocked fallopian tubes on HSG. All patients were offered diagnostic/operative laparoscopy. Results: There was a statistical significance differences between laparoscope & HSG in diagnosis of proximal & distal occlusion, adhesion and hydrosalpnix in fallopian tubes. Conclusion: HSG should be considered first-choice imaging modality in the assessment of tubal patency. Laparoscopy with dye test is the procedure of choice in the patient with abnormal HSG for further confirmation and assessment.
Diagnostic evaluation of tubal patency in a tertiary care hospital
International Journal of Research in Medical Sciences
Background: Infertility has always been one of the most elusive symptom complexes that perplex the best gynecologists. Amongst female factors, tubal factors are responsible for 25-30% of infertility. Hysterosalpingography and diagnostic laparoscopy with chromopertubation are widely used in the evaluation of tubal factors of infertility. Aim of the study was to compare hysterosalpingography and laparoscopy in the diagnosis of tubal patency in infertile patients.Methods: In this study 50 patients of infertility were evaluated prospectively in the Department of Obstetrics and Gynecology, Government Medical College, Jammu from April 2019 to March 2020. The findings of HSG and laparoscopy were compared.Results: Mean age at presentation for primary infertility was 28.6±4.20 years and for secondary infertility it was 32.1±3.84 years. Majority of patients of primary (77.6%) and secondary infertility (54.5%) had duration of infertility of 1-5 years in our study. The sensitivity...
Diagnostic laparoscopy in the evaluation of female factor infertility
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2017
Background: Infertility is a global problem, with more than 70 million couples suffering every year. In India 10-15% of populations are suffering from infertility. All these people need accurate diagnosis and treatment. Among the many investigations available to evaluate the female partner of the infertile couples, laparoscopy is relatively recent and considered gold standard for pelvis evaluation. The objective of the study was to study the different causes of female factor infertility with diagnostic laparoscopy.Methods: This is a prospective study done on 50 infertile females who attended infertility clinic of department of OBG, ESIC MC and PGIMSR, Rajajinagar, Bengaluru from September 2013 to 2015. Both primary and secondary infertility females were included in this study. These patients underwent diagnostic laparoscopy in premenstrual phase (7, 8, 9th day of menstrual cycle) after conducting thorough clinical and biochemical examinations.Results: In the present study total 50 i...
Fertility & Reproduction, 2020
Background: Tubal evaluation is an integral part of the evaluation of female infertility. Hysterosalpingography (HSG) is the radiographic evaluation of the uterus and fallopian tubes, which has been used as a first-line test for tubal assessment since 1920s. Laparoscopy is considered to be the gold standard for the diagnosis and management of tubo-peritoneal pathology. The objective of this study is to evaluate and compare the diagnostic value of both HSG and laparoscopy for assessment of tubal occlusion. Methods: This is a prospective cross-sectional study. Laparoscopic chromopertubation was conducted on 125 consecutive infertile women who attended the “Infertility Management Center” from October 2018 to September 2019. All patients had HSG performed in the radiology department of different hospitals. Laparoscopic findings were used as a reference standard to analyze the findings of HSG for tubal occlusion. Data were analyzed by SPSS software (version 16). Results: Normal HSG findi...
Diagnostic Laparoscopy in Infertility -A Retrospective study
Infertility affects approximately 10% of the population.One third (30%) of infertility can be attributed to male factors, and about one third (30%) can be attributed to female factors. In about 20% of cases infertility is unexplained, and the remaining 10% of infertility is caused by a combination of problems in both partners. Diagnostic laparoscopy is the gold standard in diagnosing tubal pathology and other intra-abdominal causes of infertility. Objective: To evaluate the role of laparoscopy in the diagnosis of infertility. Study design: Retrospective study. Setting: Department of Obstetrics and Gynaecology, K.S. Hegde Charitable hospital, Mangalore from July 2006 to December 2007. Methods: Fifty infertile women underwent diagnostic laparoscopy during the study period. Couples who had not lived together for at least 12 months, and those with male factor infertility were excluded. Laparoscopy was scheduled in the proliferative phase of the menstrual cycle. Results: Of thefifty women studied, 34 (64%) had primary infertility while 16 (36%) secondary infertility. Laparoscopy revealed normal findings in 8 (23.5%) with primary infertility and 2 (12.5%) with secondary infertility. The common finding was tubal blockage in 9 (26.5%) and 4 (25%) of primary and secondary infertility respectively. Polycystic ovaries were detected in 4 (11.7%) of primary infertility and 1 (6.25%) in secondary infertility. Endometriosis was found in 5 (14.7%) with primary infertility and 1 (6.25%) in secondary infertility group. Pelvic inflammatory disease (PID) was found in 1 (2.9%) and 3 (18.7%) of primary and secondary infertility respectively. Peritubal and periovarian adhesions were detected in 3 (8.8%) with primary infertility and 3 (18.7%) in secondary infertility. Fibroids were found in 3 (8.8%) and 1 (6.25%) in primary and secondary infertility respectively. Ovarian cyst detected in 1 (2.9%) in primary infertility and 1(6.25%) in secondary infertility. Conclusion: The most common cause responsible for infertility was tubal occlusion in both primary and secondary infertility group. Laparoscopy is necessary in establishing diagnosis of female infertility.