[A prospective study on causal factors of female infertility with laparoscopy and transvaginal B-ultrasound]

To study the casual factors of female infertility with laparoscopy and B-ultrasound.

Eighty-five infertile women were evaluated by serial transvaginal B-ultrasound scans for follicular development and ovulation and by laparoscopic examinations 2 to 6 days after ovulation.

The patterns of follicular development and ovulation detected by B-ultrasound were: (1) ovulation from normal follicle (ONF) (56.47%); (2) ovulation from two follicles at the same time (O2F) (5.88%); (3) ovulation from small follicle (OSF) (16.47%); (4) ovulation from polycystic ovaries (PCO) (3.53%); (5) luteinized unruptured follicle syndrome (LUFS) (7.06%); (6) anovulation (10.90%). Laparoscopic examinations showed that the incidence of partial and complete tubal obstruction was 32.94% and pelvic adhesions 35.29%. Pelvic tuberculosis was found in 20.00%, which was the main disease leading to pelvic adhesions (46.67%), and tubal obstruction (60.71%). Endometriosis (EMS) was discovered in 36 cases (42.35%), among them, 30 (83.33%) had patent tubes. The stigmas or/and corpus hemorrhagica were seen in 60 out of 70 patients in whom ovulation had been diagnosed by B-ultrasound. 6 cases were defined as "mechanically unruptured follicle syndrome".

Abnormal follicular development may result in female infertility. Pelvic tuberculosis is another main causal factor of infertility. Endometriosis related infertility may rather result from other factors than tubal obstruction. Laparoscopic examinations combined with transvaginal B-ultrasound scans are very useful approaches in the etiological study of female infertility.