ROLE OF DIAGNOSTIC LAPAROSCOPY IN TREATMENT OF SECONDARY INFERTILITY
Abstract
Background: One of the on-the-increase concerns facing reproductive-aged women is the secondary infertility, which refers to an inability to conceive after a successful pregnancy. Although different modalities of diagnosis are used, there are numerous cases which are not explainable after standard checks. A diagnostic laparoscopy has turned to be an ideal method to identify some hidden underlying pathologies in the pelvic region which cannot be initially recognized by non-invasive approach.Aim: The purpose of this research was to assess the utility of diagnostic laparoscopy in the detection of the causes and management of secondary infertility of women with inconclusive findings in the regular infertility tests. Methods: The present prospective observational research has been carried out at Ayub Teaching Hospital, Abbottabad during June, 2024, to May, 2025. Ninety Women with secondary infertile with normal baseline tests (Hormonal profile, ovulation profile, and hysterosalpingography) were taken. Diagnostic laparoscopy was carried out on all the participants to evaluate the presence of pelvic abnormalities such as tubal patency, endometriosis, pelvic adhesions, and pathologies of uterus or ovary. The results were recorded and matched with future treatment planning. Results: Of 90 participants under subjecting to diagnostic laparoscopy, 71 cases (78.9%) enjoyed abnormal findings. Comparison of the cycle-controlled discharge showed that in 24 (26.7) patients pelvic adhesions, in 21 (23.3) patients there was tubal blockage, 16 (17.8) cases with endometriosis, and 10 (11.1) cases had ovarian cysts or anomalies. The normal laparoscopic pictures were presented in 19 (21.1%) cases. Appropriate treatment schemes were formulated due to laparoscopic results in 62 (68.9%) cases whether directly by operation or by means of assisted reproductive technology, and this has demonstrated the central role in focused patient care. Conclusion: Diagnostic laparoscopy was an important investigative intervention in assessment and management of secondary infertility. It marked major pathological conditions of the pelvis that were not evident through the traditional measures and enabled specific treatment measures. Its regular application in inaccessible secondary infertility is highly advised to increase the accuracy of diagnosis and to maximize outcome of the treatment.
Keywords: Secondary Infertility, Diagnostic Laparoscopy, Pelvic Adhesions, Tubal Blockage, Endometriosis, Infertility Evaluation.
