Alice through the laparoscope: the place of laparoscopy in an infertility service

A retrospective comparison was made of the findings at laparoscopy and hysterosalpingography in 115 infertile women. In 41 of the 92 women whose hysterosalpingograms were reported as being normal, laparoscopy revealed additional pelvic abnormalities relevant to fertility, most commonly pelvic adhesions or endometriosis. This gave a false negative rate of 44% for hysterosalpingography. Conversely, in the 23 women whose hysterosalpingograms were abnormal (usually blockage at one or other cornua), laparoscopy showed no abnormality in six (a false positive rate of 26% for hysterosalpingography). These figures are compared with data extracted from the literature, and a plea is made for earlier laparoscopy in the investigation of infertility.