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International Journal of Reproductive BioMedicine
Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences of Yazd
ISSN: 1680-6433 EISSN: 1680-6433
Vol. 15, No. 12, 2017, pp. 787-794
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Bioline Code: rm17092
Full paper language: English
Document type: Research Article
Document available free of charge
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International Journal of Reproductive BioMedicine, Vol. 15, No. 12, 2017, pp. 787-794
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Does laparoscopy still has a role in modern fertility practice?
Mahran, Ahmad; Abdelraheim, Ahmed R; Eissa, Abdelrahman & Gadelrab, Mohamed
Abstract
Background: More than 3 decades after the introduction of in vitro fertilization
(IVF) and despite the improved success rates of assisted reproductive technologies,
the argument for performing laparoscopy as a part of the infertility workup still
stands.
Objective: To evaluate the role of laparoscopy±hysteroscopy in diagnosis and
management of infertility in our setting in view of modern fertility practice.
Materials and Methods: This case control study was carried out on 600 infertile
women subjected to laparoscopy or combined laparoscopy and hysteroscopy at
endoscopy unit in Minia University Hospital, Egypt during the period from January
2012 to December 2014.
Results: The causes of infertility as identified by laparoscopy±hysteroscopy were
polycystic ovary syndrome (25.1%), tubal factor (30%), uterine cause (4%), and
endometriosis (2.7%). No cause was identified in 38.2% of cases. Based on
operative findings, women were treated with different options. Expectant
management was used in 92 cases (15.3%). Ovulation induction with anti-estrogens
or gonadotropins was used in 372 cases (62%). Sixty cases (10%) had intrauterine
insemination and sixty four cases (10.7%) underwent in vitro fertilization (IVF) /
intracytoplasmic sperm injection (ICSI) treatment. Within 1 yr after laparoscopy,
180 cases achieved pregnancy (30%). The most favorable outcome was recorded in
women with unexplained infertility (36.7% of cases got pregnant) followed by
women with polycystic ovary syndrome (27.8%). Participants with uterine and tubal
infertility factor achieved pregnancy in 25% and 22.8% of cases, respectively. The
worst outcome was recorded in women with endometriosis.
Conclusion: Laparoscopy still has an important role in the diagnosis and treatment
of infertility.
Keywords
Infertility; Laparoscopy; Hysteroscopy.
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