Firmal P, Yadav R, Agrawal S
Lady Hardinge Medical College and Smt Sucheta Kriplani (SSK) Hospital , New Delhi , India.
J Obstet Gynaecol. 2015 May;35(4):386-8. doi: 10.3109/01443615.2014.960821. Epub 2014 Oct 17.
Laparoscopy is considered as the preferred modality for the diagnosis of pelvic pathology but its timing and use in the investigation of infertility is an area of debate. A prospective observational study was conducted between 1 November, 2009 and 31 March, 2011, in which 30 women with unexplained infertility with at least three failed cycles of COH and IUI were included and subjected to laparohysteroscopy. On laparoscopy, pelvic abnormalities were found in 11 (36.7%) women. On hysteroscopy, intrauterine lesions were detected in two (6.7%) of the women. The commonest pelvic pathology detected was adhesions followed by minimal to mild endometriosis. Operative procedures were done in nine (30%) cases. Since laparoscopy was not only diagnostic but also therapeutic in a significant number of cases, it was concluded that laparoscopy is beneficial following failure of empirical treatment in women with unexplained infertility while the routine use of hysteroscopy requires further assessment.
腹腔镜检查被认为是诊断盆腔病变的首选方式，但其在不孕症检查中的时机和应用仍是一个有争议的领域。在2009年11月1日至2011年3月31日期间进行了一项前瞻性观察研究，纳入了30例不明原因不孕症且至少经历了三个周期的控制性卵巢刺激（COH）和宫腔内人工授精（IUI）失败的女性，并对其进行了宫腹腔镜检查。在腹腔镜检查中，11例（36.7%）女性发现盆腔异常。在宫腔镜检查中，2例（6.7%）女性检测到宫腔内病变。检测到的最常见盆腔病变是粘连，其次是轻度至中度子宫内膜异位症。9例（30%）病例进行了手术操作。由于腹腔镜检查在相当数量的病例中不仅具有诊断作用，还具有治疗作用，因此得出结论，对于不明原因不孕症女性，经验性治疗失败后进行腹腔镜检查是有益的，而宫腔镜检查的常规应用需要进一步评估。
