Does laparoscopy still has a role in modern fertility practice?

Area of Science:

• Reproductive Medicine
• Minimally Invasive Surgery
• Gynecological Endoscopy

Background:

• Despite advances in assisted reproductive technologies (ART), the diagnostic value of laparoscopy in infertility workups persists.
• Laparoscopy offers a direct visual assessment of pelvic organs, aiding in the diagnosis of conditions affecting fertility.

Purpose of the Study:

• To evaluate the diagnostic and therapeutic role of laparoscopy, with or without hysteroscopy, for infertility management.
• To assess the effectiveness of surgical interventions and subsequent fertility treatments based on laparoscopic findings.

Main Methods:

• A case-control study involving 600 infertile women undergoing laparoscopy or laparoscopy-hysteroscopy.
• Data collected between January 2012 and December 2014 at Minia University Hospital, Egypt.

Main Results:

• Laparoscopy identified key infertility causes: tubal factor (30%), polycystic ovary syndrome (25.1%), uterine factors (4%), and endometriosis (2.7%). No cause was found in 38.2% of cases.
• Following diagnosis, 30% of women achieved pregnancy within one year. Success rates varied by diagnosis, with unexplained infertility (36.7%) and PCOS (27.8%) showing better outcomes.
• Treatment strategies included expectant management, ovulation induction, intrauterine insemination, and in vitro fertilization/intracytoplasmic sperm injection.

Conclusions:

• Laparoscopy continues to play a significant role in the comprehensive diagnosis and management of infertility.
• The procedure aids in identifying treatable conditions and guiding subsequent fertility treatments, improving pregnancy outcomes.