Laparoscopic and Hysteroscopic Findings in Selected Group of Women with Unexplained Infertility

Articles in Press

Document Type : Original Article

Authors

Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

10.22074/ijfs.2023.2005476.1484

Abstract

Background: The role of laparoscopy and hysteroscopy in managing unexplained infertility (UI) is debatable because of the improved success rate of assisted reproductive technologies (ART). This study aims to assess the findings of laparoscopy and hysteroscopy in selected women with UI and determine the incidence of related pathological conditions to manage them best.

Materials and Methods: The current cross-sectional study was conducted on 96 women who attended an infertility clinic at the educational hospitals of Isfahan University of Medical Sciences from March 2018 to February 2020. Participants had one or more of the following items: had failed to conceive after 2-3 cycles of ovulation induction with clomiphene citrate and intrauterine insemination (IUI), history of pelvic infection, pelvic surgery, and ectopic pregnancy (EP). Laparoscopy and hysteroscopic findings were recorded.

Results: Fifty-nine (61.4%) women had primary infertility, while 37 (38.6%) suffered secondary infertility. In patients with primary and secondary infertility, 42.3% and 43.2% had laparoscopic abnormalities, respectively. Thirty-three point eight percent (33.8%) and 21.6% had hysteroscopic abnormalities in the primary and secondary groups, respectively. The most common findings in the two groups of infertility who had laparoscopy were endometriosis (21.8%) (p value:0.20) followed by tubal pathology (13.5%) (p value:0.95). Also, the most common intrauterine pathology found in both groups were uterine septum (7.2%) (p value:0.75) and endometritis (6.2%) (p value:0.24).

Conclusion: Based on the findings of this study, laparoscopy is recommended in UI after three failed IUI and ovarian stimulation, a history of pelvic pain, pelvic surgery, and pelvic infection; however, further study is needed on hysteroscopy in women with UI. It is yet emphasized that local practice in one’s own setting can also be effective concerning the prevalence of these pathologies.

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International Journal of Fertility and Sterility

Articles in Press, Accepted Manuscript
Available Online from 31 December 2023

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