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Research and Reports in Gynecology and Obstetrics | Volume 3
November 14-15, 2019 | Singapore
Obstetrics and Gynecology
4th International Conference on
Diagnosing endometriosis and pelvic inflammatory disease on laparoscopy in women
with unexplained infertility: The very existence of this terminology is doubtful
Sonal Agarwal
Shanti Mukand Hospital, India
T he term unexplained infertility (UI) was previously
used for couples in which standard investigations like
semen analysis, ovulation tests and tubal patency tests
were normal with a prevalence of 30-40% of total infertile
population. Some minor dysfunctions like endometriosis,
undiagnosed pelvic infection and subtle ovulatory
dysfunctions are misdiagnosed as UI creating a dilemma
whether term UI really exists or not. Scientific curiosity
must come into action through hystero-laparoscopy to
reach a more pragmatic approach which considers both
diagnosis and treatment at the same time. The increasing
necessity of identifying a specific cause of infertility has
emerged due to availability of targeted interventions. Thus,
it is important for couples with UI to receive individualized
treatment based on their actual cause of infertility
diagnosed by laparoscopy. Prospective observational
study has been done from March 2016 to February 2018
for 192 women to diagnose subtle dysfunction through
laparoscopy who had unexplained infertility as their
differential diagnosis. The prevalence of different lesions
diagnosed at laparoscopy which were not detected on
2D/3D USG/HSG was calculated. Management was done
accordingly. Laparoscopically detected abnormalities were
common in both primary and secondary infertility group.
Mild and minimal endometriosis was diagnosed in 41.67%
females and pelvic inflammatory disease component in
form of extravasation of dye and pelvic adhesions was
seen in 38.5% of women. These two abnormalities were
the most common in such women. Other abnormalities
as sacculated tubes, para-ovarian cyst and fimbrial cyst
was diagnosed in 4.2%, 2% and 3.6% cases respectively.
There was no major surgical or anesthetic complication
in any of our patients other than mild abdominal
discomfort and nausea/vomiting. Meticulous screening of
women with possibility of hidden intrauterine and extra-
uterine infections should be carried out. Thus, diagnostic
laparoscopy is an integral part in the evaluation of cases
before tagging them as “unexplained.”
Speaker Biography
Sonal Agarwal has completed her national board fellowship in reproductive
medicine fromBACC Health careMilan Bengaluru. She is presently working
as consultant (Infertility Specialist) at Shanti Mukand hospital Delhi. She
has over 30 publications that have been cited over 100 times and has been
serving as an editor/reviewer of reputed Journals.
e:
Sonal Agarwal, Res Rep Gynaecol Obstet, Volume:3
DOI: 10.35841/2591-7366-C3-008