Hovav Y, Hornstein E, Almagor M, Yaffe C
Department of Obstetrics & Gynecology, Bikur Cholim Hospital, Jerusalem, Israel.
J Assist Reprod Genet. 1998 Oct;15(9):535-7. doi: 10.1023/a:1022578019260.
Our purpose was to compare the diagnostic efficacy of laparoscopy between primary and secondary infertility and to define a subgroup in which the positive findings are low.
A retrospective review of the cases of 206 infertile women who underwent laparoscopy was conducted.
Eighty-two (39.8%) patients were found to have evidence of pelvic disease--20 (22.2%) with primary infertility and 62 (54.3%) with secondary infertility. The ratio of positive findings in secondary infertility was significant in comparison with the positive findings in primary infertility. In only 3 of the 20 patients with primary infertility was there no history of an abdominal operation, pelvic inflammatory disease, or an abnormal hysterosalpingography. Of the 62 women who suffered secondary infertility and had positive findings in laparoscopy, 15 had no history of suspect findings.
The diagnostic yield of laparoscopy for primary infertility in the absence of indications of mechanical factors is low. Therefore the need for diagnostic laparoscopy in these cases should be reconsidered.
我们的目的是比较腹腔镜检查在原发性不孕和继发性不孕中的诊断效能，并确定一个阳性发现率较低的亚组。
对206例接受腹腔镜检查的不孕女性病例进行回顾性分析。
82例（39.8%）患者有盆腔疾病证据——20例（22.2%）原发性不孕患者和62例（54.3%）继发性不孕患者。继发性不孕的阳性发现率与原发性不孕相比有显著差异。20例原发性不孕患者中只有3例没有腹部手术史、盆腔炎病史或子宫输卵管造影异常。在62例继发性不孕且腹腔镜检查有阳性发现的女性中，15例没有可疑发现史。
在没有机械因素指征的情况下，腹腔镜检查对原发性不孕的诊断率较低。因此，这些病例中诊断性腹腔镜检查的必要性应重新考虑。
