ANALYSIS OF LAPAROSCOPIES IN THE MANAGEMENT OF THE INFERTILE COUPLE
Abstract
Background. Hysterosalpingography (HSG) and diagnostic laparoscopy with chromopertubation are two widely used diagnosic methods to determine tubal function in infertile women.The diagnostic value of HSG and laparoscopy is still a matter for much debate. In the retrospective analyses we wanted to evaluate the HSG and laparoscopy as diagnostic and therapeutic procedure in the infertile patients.
Materials and methods. Three hundreds and sixty two patients treated at University Department of Obstetry and Gynecology in Ljubljana because of infertility were analysed in the year 2000 and 2001. Laparoscopy was done in all 362 patients and HSG before the laparoscopy was done in 185 patients.
Results. The laparoscopy was done in 215 patients because of primary sterility and in 147 patients because of secondary sterility. The patology was found in 79% of the patients (myomas in 8%, polycystic ovaries (PCO) in 19%, endometriosis in 27%, tubo-ovarian adhesions in 46%).Considering the tubal factor of infertility sensitivity of HSG was 68%, specificity 52%, PPV 55% and NPV 64%.
Conclusions. Considering the results we found the laparoscopy as diagnostic and therapeutic method in infertile patients very useful and important and HSG as a method of limited value.
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References
Mishell D, Stenchever M, Droegemueller et alComprehensive Gynecology, 3rd ed. Part five:reproductive endocrinology and infertility. St. Louis: Mosby, 1997: 1113–54.
Hutchins CJ. Laparoscopy and hysterosalpingography in the assessment of tubal patency. Obstet Gynecol 1986; 67: 718–21.
Rice JP, London SN, Olive DL. Revaluation of histerosalpingography in infertility investigation. Obstet Gynecol 1986; 67: 718–21.
Okonofua FE, Essen UI, Nimalaraj T. Histerosalpingography versus laparoscopy in tubal infertility: comparison based on findings at laparotomy. Int J Gynaecol Obstet 1989; 28: 143–7.
Duff DE, Fried AM, Wilson EA, Haack DG. Histerosalpingography and laparoscopy: a comparative study. Am J Radiol 1983; 141: 761–3.
American Fertility Society. Revised American Fertility Society classification of endometriosis. Fertil Steril 1985; 43: 351–2.
Swart P, Mol BWJ, Veen F, Beurden M, Redekop WK, Bossuyt PMM. The accuracy of hysterosalpigography in the diagnosis of tubal pathology:a meta-analysis. Fertil Steril 1995; 64: 486–91.
Marcoux S, Maheux R, Berube S. Laparoscopic sugery in infertile women with minimal or mild endometriosis: Canadian Collaborative Group in Endometriosis. N Engl J Med 1997; 337: 217–22.
Vogler A, Tomaževič T, Ribič-Pucelj M. Vloga endoskopske kirurgije pri neplodnih ženskah z minimalno in blago endometriozo. In: Kralj B, Denona V eds. Zbornik. II. kongres ginekologov in porodničarjev Slovenije. Portorož: Združenje ginekologov in porodničarjev Slovenije, 2000: 47–9.
Ribič-Pucelj M, Tomaževič T, Vogler A, Meden-Vrtovec H, Vrtačnik-Bokal E. Kirurško zdravljenje policističnih jajčnikov pri neplodnih ženskah. In: Kralj B, Denona V eds. Zbornik. II. kongres ginekologov in porodničarjev Slovenije. Portorož: Združenje ginekologov in porodničarjev Slovenije, 2000: 59–61.
Maubon AJ, Graef M, Boncoeur-Martel MP, Rounaet JP. Interventional radiology in female infertility:technique and role. Eur Radiol 2001; 11: 771–8.
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