Laparoscopic Assessment of the Tubo Ovarian Relationship in Unexplained Infertility

Background: Unexplained infertility is usually a diagnosis of exclusion. Thus, there must be an absence of an identifiable cause of infertility despite thorough testing and medical investigation demonstrating tubal patency, normal semen parameters, regular ovulation, normal ovarian reserve, and a normal endometrial cavity.

Aim: This study aims to assess the prevalence of abnormal tubo-ovarian relationship in women with unexplained infertility by using laparoscopy.

Methodology: This was a prospective study which was conducted on 30 couples with unexplained infertility. Evaluation of the tubo ovarian relation with laparoscopy for patient with unexplained infertility who desire spontaneous pregnancy. The main object of the corrective procedure is to get free mobile fallopian tube along with satisfactory tubo-ovaian relation.

Results: There were 53.3% of cases had disturbed tubo-ovarian relation, many corrective measures done by laparoscopy, such as adhesiolysis for 30% of cases, excision of cysts for 6.7% of cases, MSH for 16.6% of cases and cauterization of endometriotic patches for 16.6% of cases. In the present study a pregnancy rate of 53,3% (9/16) was seen in cases that showed disturbed tubo ovarian relation and required operative intervention higher than other cases with no detected pathology (4/14) 47.7%. We were able to achieve a higher conception rate among cases owing to operative procedure.

Conclusions: The ovum pick up by the fimbrial end of the tube is an essential determining factor for female infertility. The present study confirmed that laparoscopy provided a precise diagnosis of tubo ovarian factor and may switch the initial treatment of unexplained infertility.