Diagnostic laparoscopy in primary and secondary infertility

الملخص EN

Objective : to compare the diagonstic effficacy of laparoscopy between primary and secondary infertility and to define the abnormalities visualized in the pelvis.

Design : Prospective study.

Setting : Azadi general hospital in Kirkuk city, in the north of Iraq.

Patients and Methods : One hundred and sixty nine women underwent laparoscopy as a part of investigations for infertility.

107 patients were suffering from primary infertility and 62 patients were suffering from secondary infertility.

Results : Uterine abnormalities as uterine fibroids were found in 13.1 % of primary infertility group (1st group) and 14.5 % of secondary infertility group (2nd group).

Unicorn uterus with presence of only right tube was found in one patient in the 1st group (0.9 %).

Unilateral tubal pateny could not be elicited in 4.7 % of 1st group and 16.1 % in the 2nd group while bilateral tubal pateny could be elicited in 16.8 % of the 1 s1 group and 35.5 of 2nd group.

Pelvic adhesions were found in 19.6 % of 1st group and 25.2 % of 2 % nd group.

Endometriosis was found in 12.1 %, 2.8 % in 1st and 2nd group respectively.

Polycystic ovaries were found in 43.9 %, 11.2 % in 1st and 2nd group respectively.

Conclusion : Although the incidence of tubal factor and pelvic adhesions are significantly higher in the secondary infertility group, polycystic ovaries and endometriosis are more commonly visualized in the primary infertility group in this series and still there is considerable number of other pelvic abnormalities in the 1st group.

So laparoscopy is valuable in both groups especial1y if laparoscopic therapeutic procedures are performed at the same time when indicated as in clomid resistant polycystic ovaries, endometriosis and pelvic adhesions.