Diagnostic laparoscopy of subfertile women of non demonstrable causes

From 1983 to 1987, seventy-five subfertile women of non demonstrable causes in the Infertility Unit, Department of Obstetrics & Gynaecology at the Siriraj Hospital, Mahidol University had diagnostic laparoscopy. Thirty-five of seventy-five subfertile women (46.66%) had pelvic pathologies which were not suspected by clinical examination. The two common pathologies of subfertile women of non demonstrable causes were pelvic inflammatory diseases (18.6%: pelvic and peritubal adhesion) and mild endometriosis (16%). Pathophysiology of subfertile women with chronic pelvic inflammatory disease was mainly due to disturbances of tubal ovarian anatomy and function. The possible mechanism of mild endometriosis which may interfere with pregnancy was discussed in the text. The results of this study indicated that diagnostic laparoscopy should be performed in all subfertile women of non demonstrable causes to find out the pelvic pathology in order to correct the causes of infertility.