Objective: To describe the different causes of infertility based on findings of diagnostic laparoscopy and their comparative frequency in primary and secondary infertility.
Study design: A cross-sectional study.
Place and duration of study: Obstetrics and Gynaecology Unit of Hayatabad Medical Complex, Peshawar, from January to December 2005.
Methodology: All patients undergoing diagnostic laparoscopy for primary or secondary infertility were included. Male factor infertility cases was excluded. Frequency of the causes and finding was determined.
Results: One hundred and thirty six (70.46%) patients with primary and 57 (29.54%) with secondary infertility underwent diagnostic laparoscopy. Seventy (51.47%) with primary and 26 (45.51%) with secondary infertility had no visible abnormality. Bilateral tubal blockage was found in 32 (23.53%) primary and 16 (28.07%) cases of secondary infertility. Dense pelvic adhesions forming adnexal mass were found in 9 (6.61%) and 6 (10.5%) of primary and secondary respectively. Two cases each of bicornuate uterus and double uterus in primary infertility patients. Ovarian pathology was found in 18 (13.23%) primary and 4 (7.01%) cases of secondary infertility. PCO (polycystic ovaries) were detected in 12 (8.82%) and 2 (3.5%) cases of primary and secondary infertility respectively. Endometriotic cysts and deposits were found in 15 (10.29%) cases of primary and 3 (5.26%) cases of secondary infertility.
Conclusion: Tubal disease is a common factor responsible for infertility and diagnostic laparoscopy is a valuable technique for complete assessment of female infertility and making treatment decisions according to the cause.