Diagnostic Laparoscopy in the Evaluation of Female Factors in Infertility in Kashmir Valley

To evaluate the female factors in infertility using laparoscopy in Kashmiri women. 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. 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. 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.