Place of laparoscopy in infertility - judgement of the pelvic organs anatomical and functional states
Gyorgy Szendei, Janos Inovay, Peter Somos, Istvan Sziller, Janos Hidvegi, Janos Tanyi, Anton Borzsonyi, Zoltan Papp
Med Sci Monit 1998; 4(6): CR945-950
Objectives: The authors evaluated infertility couples by means of a given protocol. One of its steps was the laparoscopic judgement of the pelvic organs anatomical and functional states.Methods: Between the first of September, 1991 and the first of December, 1996, 186 sterile patients underwent a laparoscopic (LSK) check up. In 124 cases, we compared previously performed hysterosalpingography (HSG) and laparoscopic results. In 62 cases without HSG, LSK was the first choice.Results: Due to pelvic adhesions (keeping to the basic principle of minimal invasive surgery) we performed adhesiolysis in 96 patients (51.61%). We discovered endometriosis in 44 patients (23.6%). Following the evaluation of laparoscopic results, due to destroyed tubes, we suggested assisted reproductive methods in 35 patients(18.8%). During the examined period 57 spontaneous pregnancies were registered (30.6%) out of which 49 matured live birth (26.3%), and 8 produced spontaneous abortions (4.3%).Conclusion: The authors suggest that operative laparoscopy is a reliable diagnostic and therapeutic method in the evaluation of infertility patients, being more effective than HSG. It is an indispensable technique in the diagnosis and treatment of pelvic endometriosis, the more and more frequent pelvic inflammatory diseases, and adhesions due to previous laparotomies.
Keywords: Infertility, adhesiolysis, Pelvic Inflammatory Disease, Endometriosis, operative (surgical) laparoscopy