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Role of diagnostic laparoscopy in the management of female infertility

机译:诊断性腹腔镜检查在女性不育症治疗中的作用

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Background: With recent improvements in the assisted reproductive technology (ART), there has been a growing tendency that bypasses diagnostic laparoscopy and proceeds directly to ART. Therefore, the value of diagnostic laparoscopy in current fertility practice is under debate. The objective of this study was to study role of diagnostic laparoscopy in the management of unexplained infertility. Methods: 50 case of primary or secondary infertility with unknown etiology that underwent diagnostic laparoscopy in a tertiary care institute. Diagnostic laparoscopy was offered as a final option for patients with normal diagnostic workup for infertility like semen analysis, ovulation testing, ultrasound examination, hysterosalpingogram, and testing for ovarian reserve. Outcomes in terms of cause detected and immediate laparoscopic management done which is helpful in improving fertility. Results: Out of 50 cases studied, in 27 cases we found most probable cause of infertility and in remaining 23 cases we did not found any cause of infertility. Of the 27 cases, 11 cases had endometriosis, 5 cases had multiple pelvic adhesions, 5 cases of bulky cystic ovaries, 3 cases had combined endometriosis with pelvic adhesions and 2 cases had bilateral tubal blockade contrary to hysterosalpingographic findings, 1 case showed combination of cystic ovaries with pelvic adhesions. Intraoperative adhesiolysis, endometriosis ablation, and ovarian drilling were done in respective cases. Conclusions: We concluded that Laparoscopy has important role in the diagnosis and treatment of unexplained infertility. It also helps in Prediction and improvement of success rate of assisted reproductive technologies like IUI and IVF.
机译:背景:随着辅助生殖技术(ART)的最新改进,绕过诊断性腹腔镜检查并直接发展为ART的趋势越来越大。因此,腹腔镜诊断在当前生育实践中的价值尚在争论中。这项研究的目的是研究诊断性腹腔镜检查在无法解释的不育症管理中的作用。方法:50例病因不明的原发性或继发性不育症,在三级医疗机构接受了腹腔镜诊断。诊断性腹腔镜检查是精液分析,排卵检查,超声检查,子宫输卵管造影检查和卵巢储备检查等不孕症诊断正常的患者的最终选择。在发现病因方面取得成果,并立即进行腹腔镜处理,这有助于提高生育能力。结果:在研究的50例病例中,有27例我们发现了最可能的不孕原因,而在其余23例中,我们没有发现任何不孕原因。 27例中,子宫内膜异位症11例,多处盆腔粘连5例,大卵巢囊肿5例,子宫内膜异位合并盆腔粘连3例,双侧输卵管阻塞与子宫输卵管造影相反,1例合并囊性卵巢有骨盆粘连。分别在术中进行了粘膜溶解,子宫内膜异位消融和卵巢钻探。结论:我们得出结论,腹腔镜检查在无法解释的不孕症的诊断和治疗中具有重要作用。它还有助于预测和提高辅助生殖技术(如IUI和IVF)的成功率。

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