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Article Type

Original Study

Abstract

Objective Infertility is a growing challenge for all gynecologists worldwide. There is no definite answer as to what should be the best approach to the management of the couples with unexplained infertility (UI). This study aimed to evaluate laparoscopic diagnostic findings that were helpful in planning the protocol for management of cases of UI. Patients and methods This retrospective study was conducted in Shibeen El Kom Teaching Hospital, Egypt, from January 2012 to October 2017. Data of 250 infertile couples were collected from patient case records and subjected to laparoscopy or combined with hysteroscopy. Intraoperative findings such as endometriosis, pelvic adhesion, presence of peritubal adhesion, pelvic inflammatory disease, uterine polyp, and septum were recorded. Results The present study showed that performing laparoscopy in UI allowed to see and treat abnormalities that might interfere with a woman's ability to conceive a pregnancy. Our study revealed 46% cases had no detectable pathology on laparoscopy; 22 and 16% had minimal and mild endometriosis, respectively; 28% had tubal and perifimbrial adhesions; and 4% had pelvic inflammatory disease. Laparoscopy findings led to a change of treatment planned for the patients. They were advised either direct intrauterine insemination or assisted reproductive technology/intracytoplasmic sperm injection in cases of severe and moderate endometriosis, without time consumption. Conclusion Laparoscopic procedure is a safe and more precise tool in comprehensive evaluation of UI and can detect various structural abnormalities. This helps in formulating specific plans of management.

Keywords

Assisted reproductive technology/intracytoplasmic sperm injection, intrauterine insemination, laparoscopic, ovulation stimulation, unexplained infertility

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