Abstract

For women, problems with impregnation arise mainly from either operational problem in the Fallopian tube or uterus or problems regarding releasing eggs. Polycystic Ovary Syndrome (PCOS) is a health problem that affects 1 in 10 women of child rearing age. PCOS is also now a common and treatable cause of subfertility. To find out the diverse types of pelvic pathologies, female subfertility along with PCOS may be treated through Diagnostic Laparoscopy where a small incision is made in the abdomen which is a thin laparoscope which is a flexible microscope with a light at the end is inserted through it.
Objectives: To reassess the importance of Diagnostic laparoscopy in subfertility investigation treatment plan determination.
Methods: This study was carried out in Government and Private Hospital at Patuakhali, Bangladesh. The study enrolled 100 patients with subfertility problems who attended in that institution during the study time. The institution was chosen because of its available facilities for the infertile women and patient with PCOS and other subfertility related diseases. Female patient’s, who have significant infertile condition due to abdominal abnormalities, PCOS, endometriosis and others, assessment was carried out before starting the endoscopic procedures followed by thorough general, abdominal and pelvic examinations then Laparoscopy was performed under general anaesthesia.
Results: Patient’s age ranged from 18 to 42 years and with subfertility duration >1 year were selected as study sample. The study was conducted on 100 female patients with problems regarding subfertility. Uterine pathology data shows that 12% of the selected patients had enlarged uterus and the uterus of 8% had smaller than normal sized uterus. Ovarian pathology data shows 32% patients had normal ovaries, 12% had peri-ovarian adhesions, 42% had polycystic ovaries (PCO), and 1% had small ovaries. 2% patient had tubo-ovarian mass, 8% had simple cysts while 3% of the patients had chocolate cysts. Tubal pathology data shows 66 patients (66%) had normal tubes. 10 patients (10%) had some form of peri-tubal adhesion. 17 patients (17%) had tubal block. Amongst them 9% patients had unilateral block and 8% patients had bilateral tubal block. 2 patients (2%) had hydrosalpinx and 2 patients (2%) had tubo-ovarian mass. The tubes could not be visualized in 3 cases due to gross adhesions. Peritoneal pathology data shows 16% had pelvic adhesions and 10% had endometriosis.
Conclusion: This study helps to re-evaluate the controversial means concerning the use of laparoscopy in subfertility work-up, the findings in the study provides a clear description of the abnormal circumstances that motivates changes in intended initial treatment plan for infertile men and women.
Keywords: Laparoscopy, Ovary, Infertility, Uterus, Fallopian tube.