September 27th, 2020

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Title:
Pelvic Inspection Using Hysteroscopy Combined with Laparoscopy in the Diagnosis and Treatment of Primary and Secondary Infertility
Authors:  Lin Ma, M.M., and Jian Huang, M.M.
  OBJECTIVE: To explore the value of laparoscopy in the diagnosis and treatment of primary and secondary infertility.

STUDY DESIGN: A total of 523 female infertility patients were recruited and underwent laparoscopic examination. Patients were divided into 2 groups according to infertility type (primary infertility [n=263] and secondary infertility [n=260]), and then according to pregnancy history the secondary infertility group was divided into 3 subgroups: 1 time, 2 times, ≥3 times. Laparoscopic examination of extent of pelvic adhesions was performed and the results analyzed.

RESULTS: Laparoscopic exploration revealed endometriosis, pelvic tuberculosis, polycystic ovary, and other diseases, in addition to ovarian tumor and endometrial polyps. Incidence of the above complications was higher in the primary infertility group than in the secondary infertility group (p<0.05). Adhesion of the pelvic cavity was found in 413 cases (79.0%), including 202 cases in the primary infertility group (76.8%) and 211 cases in the secondary infertility group (81.15%). The incidence rate of pelvic adhesions showed a trend of increase with an increase in number of prior pregnancies. There was a lower incidence rate of pelvic adhesions in 1-time pregnancy patients than in the ≥3-time pregnancy subgroup (p<0.05), while the difference in distribution of heavy pelvic adhesion degree was statistically significant (p<0.05).

CONCLUSION: Pelvic adhesion is an important factor in causing infertility and should be subject to tubal examination in the clinical diagnosis and treatment of primary infertility, especially laparoscopy. Repeated pregnancy increased pelvic and fallopian tube diseases, which are important factors in secondary infertility.
Keywords:  fallopian tubes; hysteroscopy; infertility, female; laparoscopy; ovarian function tests; pelvic adhesion; primary infertility; secondary infertility
   
   
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