Evaluating the Role of Diagnostic Laparoscopy in Identifying Tubal and Peritoneal Factors in Female Infertility

Beena  Gupta; Prabhat Kumar  Bhagat

doi:10.51168/sjhrafrica.v5i12.1485

Authors

Beena Gupta Associate Professor, Department of Obstetrics & Gynecology, Madhubani Medical College and Hospital, Madhubani, Bihar, India
Prabhat Kumar Bhagat Associate Professor, Department of Radiodiagnosis, Madhubani Medical College and Hospital, Bihar, India

DOI:

https://doi.org/10.51168/sjhrafrica.v5i12.1485

Keywords:

Diagnostic Laparoscopy, Female Infertility, Tubal Factors, Peritoneal Factors, Endometriosis, Hysterosalpingography

Abstract

Background: Infertility affects a significant percentage of couples worldwide, with tubal and peritoneal factors being major contributors. While hysterosalpingography (HSG) is commonly used for assessing tubal patency, its limitations in accuracy make diagnostic laparoscopy a preferred choice. Laparoscopy allows direct visualization of the pelvic organs, providing a more accurate diagnosis of tubal blockages and peritoneal pathologies, such as adhesions and endometriosis, which are often undetectable through non-invasive techniques. This study evaluates the effectiveness of diagnostic laparoscopy in identifying tubal and peritoneal factors in female infertility, focusing on its role as a gold standard for infertility diagnosis.

Methods: A cross-sectional study was conducted on 50 women with primary or secondary infertility. Each participant underwent diagnostic laparoscopy following clinical evaluation and HSG. Data were collected on the presence of tubal blockages, peritoneal adhesions, and endometriosis, and results were analyzed to compare findings between primary and secondary infertility groups.

Results: Tubal factors, including bilateral tubal blockage, were identified in 32% of cases, with a similar incidence in both primary and secondary infertility. Peritoneal factors, such as pelvic adhesions and endometriosis, were present in 24% of cases, predominantly in primary infertility. Diagnostic laparoscopy revealed a higher sensitivity for detecting these factors compared to HSG, emphasizing its role in cases where non-invasive imaging was inconclusive.

Conclusion: Diagnostic laparoscopy is a valuable tool for identifying tubal and peritoneal factors in female infertility, offering high diagnostic accuracy and aiding in tailored treatment planning. Its ability to directly visualize pelvic abnormalities makes it essential in the comprehensive evaluation of infertility.

Recommendations: Laparoscopy should be considered in routine infertility workups, especially for patients with unexplained infertility or inconclusive HSG results. Further research on combining laparoscopy with minimally invasive treatments may improve fertility outcomes.

References

Argentino GL, Bueloni-Dias FN, Leite NJ, Peres GF, Elias LV, Bortolani VC, Padovani CR, Spadoto-Dias D, Dias R. The role of laparoscopy in the propaedeutics of gynecological diagnosis. Acta cirurgica brasileira. 2019;34(01):e20190010000010.

Dutta S, Mazumder P, Mishra D, Saha JK. Study on Comparative Diagnostic Efficacy of HSG & Laparoscopy in Infertility. Journal of Evolution of Medical and Dental Sciences. 2020 Mar 23;9(12):937-43.

Varlas V, Rhazi Y, Cloțea E, Borș RG, Mirică RM, Bacalbașa N. Hysterolaparoscopy: a gold standard for diagnosing and treating infertility and benign uterine pathology. Journal of Clinical Medicine. 2021 Aug 23;10(16):3749.

Jahan S. Role of laparoscopy in infertility. BIRDEM Medical Journal. 2012 Oct 22;2(2):99-103.

Maiti GD, Lele P. Hysterosalpingography (HSG), hysteroscopy and laparoscopic evaluation of female genital tract of patient attending tertiary infertility center and correlation of various modalities. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2018 Apr 1;7(4):1597.

Zhang Y, Zhu Y, Sui M, Guan X, Sun J. Diagnosing and Treating Infertility via Transvaginal Natural Orifice Transluminal Endoscopic Surgery versus Laparoendoscopic Single-Site Surgery: A Retrospective Study. Journal of Clinical Medicine. 2023 Feb 16;12(4):1576.

Annan JJ, Asubonteng GO, Konney TO. Experience with diagnostic laparoscopy in the evaluation of tubal factor infertility. Open Journal of Obstetrics and Gynecology. 2020 May 13;10(05):688.

Shetty SK, Shetty H, Rai S. Laparoscopic evaluation of tubal factor in cases of infertility. Int J Reprod Contracept Obstet Gynecol. 2013 Sep 1;2(3):410-3.

Choudhary R, Sinha R. EVALUATION OF HYSTEROSALPINGOGRAPHY VERSUS LAPAROSCOPY IN THE DETERMINATION OF TUBAL FACTORS IN FEMALE INFERTILITY: A HOSPITAL BASED COMPARATIVE STUDY. International Journal of Medical and Biomedical Studies. 2020;4.

Tan J, Deng M, Xia M, Lai M, Pan W, Li Y. Comparison of hysterosalpingography with laparoscopy in the diagnosis of tubal factor of female infertility. Frontiers in medicine. 2021 Oct 29;8:720401.

Khan YL, Imran S, Samreen Z. Identification of Factors Contributing to Primary Female Subfertility by Diagnostic Hystero-Laparoscopy: An Experience of Private Hospital. Journal of Shalamar Medical & Dental College-JSHMDC. 2022 Dec 30;3(2):76-80.

Khalid MA, Khurshid N, Yasin A, Afzal M, Aziz U, Hussain S. Laparoscopic Evaluation of Tubal Factors in Female Subfertility. Pakistan Journal of Medical & Health Sciences. 2022;16(12):634-.

Singh N, Pramanik KD, Bajaj M, Roy R. Diagnostic hysterolaparoscopy: An important tool in evaluation of female infertility, in beneficiaries of ESI scheme in Eastern India. Asian Journal of Medical Sciences. 2022 May 3;13(5):183-8.