[Laparoscopic assessment following failure to achieve pregnancy after intrauterine inseminations in patients with normal hysterosalpingograms].

OBJECTIVES

To assess the diagnostic benefit of laparoscopy in infertile women thought to be at low risk for altered pelvic anatomy.

DESIGN

Retrospective chart review.

PATIENTS: 127 infertile patients who underwent laparoscopic evaluation of the pelvis failing to conceive after intrauterine inseminations (IUI) with normal hysterosalpingography (HSG).

INTERVENTION: Diagnostic and/or therapeutic laparoscopy.

MAIN OUTCOME MEASURES: Presence of pelvic pathology and predictors of pelvic disease.

RESULTS

Although the hysterosalpingograms were read as normal in all women, endometriosis stage I-II was found in 64 (50,4%) patients, stage III and stage IV in 4 (3,1%). Adhaesions were diagnosed laparoscopically in 22 (17%) patients and distal tubal disease in 26 (20%). All of this abnormalities were directly treated by laparoscopic intervention. The time between HSG and laparoscopy was positively correlated with appearance of distal tubal disease and pelvic adhaesions.

CONCLUSION

Laparoscopic findings could lead to a change of treatment decisions in high number of infertile patients with normal hysterosalpingography.