Diagnostic laparoscopy in the evaluation of tubal factor in cases of infertility

Background: Tubal factor infertility accounts for a large portion of female factor infertility. The most prevalent cause of tubal factor infertility is pelvic inflammatory disease and acute salpingitis. Tubal patency can be diagnosed by hysterosalpingography (HSG) or laparoscopy with chromopertubation. The aim of this study was to determine the role of laparoscopy in the evaluation of tubal factor in infertile women.Methods: Sixty women presenting with complaints of primary and secondary infertility were investigated for tubal disease by laparoscopy at at Smt. NHL Municipal Medical College, Ahmedabad during July 2011 to September 2013. Tubal patency was tested by chromopertubation using Methylene blue dye.Results: Thirty-five (58.3%) patients were in primary infertility group while 25 (41.7%) patients were in secondary infertility group. 80% women were in the age group of 21 to 30 years. In 49% of women, the duration of infertility was between 2 to 4 years whereas 17% cases had been infertile for 6 to 10 years. Diagnostic laparoscopy and findings of chromopertubation revealed unilateral blockage in 37% of cases, bilateral blockage had seen in 23% of cases, endometriosis was seen in 9% of cases and adhesion in 7% of cases.Conclusions: Unilateral and bilateral tubal blockade was detected in 60% of cases of infertile women.

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Role of IgG Chlamydia antibody in tubal factor infertility

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20170464 ◽

2017 ◽

Vol 6 (3) ◽

pp. 837

Author(s):

Sheila Balakrishnan ◽

Anitha Malathi ◽

Geetha Raveendran ◽

Dolly Johnrose ◽

Sreekumari Radha

Keyword(s):

Chlamydial Infection ◽

Venous Blood ◽

Igg Antibody ◽

Infertile Women ◽

Tubal Factor Infertility ◽

Tubal Factor ◽

Tubal Disease ◽

The Difference ◽

Chlamydial Antibody ◽

The Relationship

Background: Chlamydial infection is considered to be one of the important causes of tubal factor infertility. This study will help to explore the relationship between positive Chlamydial infection and tubal damage in infertile women assessed by diagnostic laparoscopy. The results will help to determine whether a policy of routine screening for Chlamydia antibody is justifiable in infertile women to suspect tubal factor so that they can be taken up for laparoscopy earlier.Methods: A prospective study was performed on 158 consecutive patients who underwent laparoscopy as part of infertility evaluation. About 5 mL of venous blood was drawn preoperatively to detect Chlamydia IgG antibody in all the patients by ELISA. The laparoscopic findings were documented and the relationship to Chlamydial antibody evaluated.Results: Of the 158 patients who underwent laparoscopy, 95 patients had evidence of tubal disease as evidenced by unilateral or bilateral tubal block, peritubal adhesions, hydrosalpinx, beading of the tube and unhealthy shaggy appearance. Of the 95 patients with documented tubal disease at laparoscopy, 14 (14.7%) had antibodies to Chlamydia. Of the 63 patients with normal tubes, 12 (19%) had Chlamydial positivity. The difference is not statistically significant. However of the 26 patients who were positive for Chlamydia antibodies 14 patients (53.8%) had abnormal tubes. Out of the 158 patients who underwent laparoscopy 26 patients were positive for Chlamydia. Hence the prevalence in our study is 16.4% (26/158). The sensitivity is 14.7% and the specificity is 81%.Conclusions: This study showed no difference in Chlamydial positivity between infertile women with abnormal tubes and those with normal looking tubes in our population. The absence of Chlamydial antibodies cannot be taken as a marker for normal tubes. Hence screening for chlamydial antibody can neither be used as a screening test for tubal factor infertility nor to decide on the need for laparoscopy in the present population.

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Evaluation of role of laparoscopy in determining etiology of infertility

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20175235 ◽

2017 ◽

Vol 6 (12) ◽

pp. 5322

Author(s):

Hema K. R. ◽

Lalitha H. S.

Keyword(s):

Diagnostic Laparoscopy ◽

Secondary Infertility ◽

Peritoneal Disease ◽

College Hospital ◽

Medical College ◽

Uterine Anomalies ◽

Morphological Defects ◽

Indispensable Tool ◽

Infertility Patients

Background: Although population explosion is a major problem in India, infertility appears to be a problem in 5-15% of Indian population. All these patients require evaluation. Laparoscopy plays a valuable role in the diagnosis of infertility. After thorough clinical examination and specific investigations, diagnostic laparoscopy is performed to detect patency of tubes, morphological defects in uterus, ovaries and tuboperitoineal factors. This study was conducted to assess the role of diagnostic laparoscopy in the investigation of female infertility and to evaluate the various causes of infertility like endometriosis, PCOD tubal and peritoneal factors, uterine anomalies, tuberculosis etc. by using diagnostic laparoscopy.Methods: Study was carried out in 60 infertile patients attending outpatient department of hospitals attached to Sri Siddhartha Medical College Hospital, Tumkur. Both primary and secondary infertility patients who were anxious to conceive and undergo diagnostic laparoscopy were evaluated. Those who were not willing and who were contraindicated for the procedure were excluded.Results: Diagnostic laparoscopy was performed in 72% of primary and 28% of secondary infertility patients. Majority of the patients of primary infertility were in age group 21-25 years and that of secondary were between 26-30 years. Majority of patients in both the groups had duration of 1-5 year of infertility. In our study tubal factors (50%) contributed to majority of the infertility causes. Complication rate was minimum and was comparable to other standard studies.Conclusions: Laparoscopic is the gold standard for diagnosing tubal and peritoneal disease, endometriosis and other pelvic pathology, because no other imaging technique gives the same degree of sensitivity or specificity. Hence diagnostic laparoscopy is an indispensable tool in the evaluation in the evaluation infertility.

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STUDY OF LAPAROSCOPIC EVALUATION OF FEMALE FACTORS IN INFERTILITY AT ANMMCH, GAYA, BIHAR

10.36106/ijsr/2733535 ◽

2021 ◽

pp. 60-62

Author(s):

Pankaj Kumar Chaudhary ◽

Anupam Chaurasia ◽

Lata Shukla Dwivedy ◽

Debarshi Jana

Keyword(s):

Diagnostic Laparoscopy ◽

Polycystic Ovaries ◽

Male Factor ◽

Secondary Infertility ◽

Infertile Women ◽

Medical College ◽

Primary Infertility ◽

Common Causes ◽

Tubal Blockage ◽

Laparoscopic Evaluation

Objective:To nd out different causes of female infertility with diagnostic laparoscopy and their comparative frequency in primary and secondary infertility. Study Design:Acase series. Place and Duration of Study: Department of Obstetrics and Gynaecology, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, August 2018 to July 2019. Methodology:All infertile women underwent diagnostic laparoscopy for primary and secondary infertility during the study period were included. Couples who had not lived together for at least 12 months, and those with male factor infertility were excluded. Data were collected on a proforma, and analysed on SPSS package for windows version 10. Frequencies were calculated for laparoscopic ndings regarding primary and secondary infertility. Results: Fifty infertile women underwent laparoscopy during the study period, 32 (64%) had primary infertility while 18 (36%) secondary infertility. Eight (25.0%) patients with primary and 2 (11.1%) patients with secondary infertility had no visible abnormality. The common nding was tubal blockage in 7 (21.9%) and 6 (33.3%) cases of primary and secondary infertility respectively. Five (15.6%) cases of primary infertility were detected as polycystic ovaries (PCO) which was not found in cases of secondary infertility. Endometriosis was found in 4 (12.5%) cases with primary infertility and 2 (11.1%) cases with secondary infertility. Pelvic inammatory disease (PID) was found in 1 (3.1%) and 2 (16.7%) cases of primary and secondary infertility respectively. Peritubal and periovarian adhesions were detected in 2 (6.3%) cases with primary infertility and 4 (22.2%) cases with secondary infertility. Fibriod was found in 2 (6.3%) and 1 (5.6%) cases of primary and secondary infertility respectively. Ovarian cyst detected in 2 (6.3%) cases with primary infertility while none was found in cases of secondary infertility. Conclusion: Most common causes responsible for infertility were tubal occlusion, endometriosis, peritubal and periovarian adhesions. Ovarian causes were seen in primary infertility only

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Comparison between hysterosalpingography and laparoscopic chromopertubation for the assessment of tubal patency in infertile women

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20174626 ◽

2017 ◽

Vol 6 (11) ◽

pp. 4825

Author(s):

Anjana Choudhary ◽

Shreya Tiwari

Keyword(s):

Uterine Cavity ◽

Moderate Degree ◽

Age Group ◽

Secondary Infertility ◽

Health Care Centre ◽

Cross Sectional ◽

Tubal Patency ◽

Infertile Women ◽

Number Of Patients ◽

History Of

Background: Infertility is a critical component of reproductive health, and has often been neglected in these efforts. The inability to have children affects men and women across the globe. Infertility can lead to distress and depression, as well as discrimination and ostracism. Hysterosalpingography (HSG) of infertile women is useful for the assessment of structure of uterine cavity, tubes and their patency. However, although a more invasive procedure such as laparoscopy (L/S) which is regarded as the most reliable method in detection of tubal pathologies in infertility.Methods: This was a Prospective cross sectional study of 50 patients with history of primary or secondary infertility selected from IPD of Jawaharlal Nehru medical College and Acharya Vinobha Bhave Rural Hospital, Tertiary Health Care Centre Located in Sawangi, Wardha, Maharashtra (India). The age group of the patients was between 18 yrs. - 45 yrs. The study population was selected depending upon the total number of patients (fitting the criteria) visiting the IPD of AVBRH Department of Obstetrics and gynecology for a period of 1 years (September 2015 to September 2016). The collected data was compiled and proper statistical formulas were applied to analyze the data collected.Results: The present study include 50 cases of both primary and secondary infertility of which 29 cases (58%) were primary infertility and 21 cases (42%) were secondary infertility. In this study the 3(6%) cases were found in the age group of <20 years followed by 16 (32%) cases in the age group of 21-25 years, 19(38%) cases were in the age group of 26-30 years while 7(14%) cases were in the age group of 31-35years the age group of 36-40 years 2(14%) and in age group > 40 years is 3(6%). In the present study, based on Kuppuswamy index most (30%) of the women had class IV socio economic status in both primary and secondary infertility. In the present study, there were 6 (28.57%) cases with History of LSCS, 7 cases (33.33%) had FTND, 6(28.57%) cases had history of abortion, and 2(9.52%) had previous ectopic pregnancy. Moderate degree of agreement was found between findings of both tests.Conclusions: The results suggest that hysterosalpingography is useful as a primary screening procedure, but laparoscopy provides a more accurate assessment of tubal patency in the investigation of infertility.

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Laparoscopy: the tool for infertility

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20175278 ◽

2017 ◽

Vol 6 (12) ◽

pp. 5544

Author(s):

Neelima P. Shah ◽

Prashant D. Shah

Keyword(s):

Blue Dye ◽

Secondary Infertility ◽

Tubal Patency ◽

Infertile Women ◽

Primary Infertility ◽

Therapeutic Laparoscopy ◽

Therapeutic Value ◽

Ovarian Pathology ◽

Infertility Patients

Background: Most of the healthy couples conceive within a year after marriage. The infertility patients have become important part of clinical practice. Diagnostic and therapeutic Laparoscopy plays major role in the management of these cases. We investigated hale 50 infertile women with laparoscopy. This study was undertaken to ascertain the diagnostic and therapeutic role of Laparoscopy in female infertility.Methods: We evaluated 50 couples having infertility. The cases of primary and secondary infertility were evaluated. The laparoscopy was done under general anaesthesia. The pelvic organs were examined, and tubal patency was tested with chromo-perturbation by using Methylene blue dye. The findings were noted. The therapeutic intervention was done in the cases where it was necessary.Results: Total 50 cases of infertility were studied. Thirty were of primary infertility and 20 were of secondary infertility. The patients with primary infertility were younger with mean age of 20 years. The duration of infertility ranged from 1.5 to 8 years. We detected total 21 (42%) patients with ovarian pathology, 5 (10%) with tubal, four (8%) with peritoneal factor 3 (6%) with endometriosis. One patient had uterine fibroid and 16 (32%) cases had normal laparoscopic findings.Conclusion: This study supported the diagnostic and therapeutic value of laparoscopy in managing infertile women. It helped in detection of pelvic pathology. It also helped to plan further management in the form of IUI or IVF.

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Where to go to in chlamydia control? From infection control towards infectious disease control

Sexually Transmitted Infections ◽

10.1136/sextrans-2021-054992 ◽

2021 ◽

pp. sextrans-2021-054992

Author(s):

Jan E A M van Bergen ◽

Bernice Maria Hoenderboom ◽

Silke David ◽

Febe Deug ◽

Janneke C M Heijne ◽

...

Keyword(s):

Chlamydia Infection ◽

Limited Evidence ◽

Future Directions ◽

Tubal Factor Infertility ◽

Effectiveness Analysis ◽

Population Prevalence ◽

Tubal Factor ◽

Health Relevance ◽

Asymptomatic Infections

ObjectivesThe clinical and public health relevance of widespread case finding by testing for asymptomatic chlamydia infections is under debate. We wanted to explore future directions for chlamydia control and generate insights that might guide for evidence-based strategies. In particular, we wanted to know the extent to which we should pursue testing for asymptomatic infections at both genital and extragenital sites.MethodsWe synthesised findings from published literature and from discussions among national and international chlamydia experts during an invitational workshop. We described changing perceptions in chlamydia control to inform the development of recommendations for future avenues for chlamydia control in the Netherlands.ResultsDespite implementing a range of interventions to control chlamydia, there is no practice-based evidence that population prevalence can be reduced by screening programmes or widespread opportunistic testing. There is limited evidence about the beneficial effect of testing on pelvic inflammatory disease prevention. The risk of tubal factor infertility resulting from chlamydia infection is low and evidence on the preventable fraction remains uncertain. Overdiagnosis and overtreatment with antibiotics for self-limiting and non-viable infections have contributed to antimicrobial resistance in other pathogens and may affect oral, anal and genital microbiota. These changing insights could affect the outcome of previous cost–effectiveness analysis.ConclusionThe balance between benefits and harms of widespread testing to detect asymptomatic chlamydia infections is changing. The opinion of our expert group deviates from the existing paradigm of ‘test and treat’ and suggests that future strategies should reduce, rather than expand, the role of widespread testing for asymptomatic chlamydia infections.

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Should Diagnostic Hysteroscopy be a Routine Procedure During Diagnostic Laparoscopy in Infertile Women?

Bosnian Journal of Basic Medical Sciences ◽

10.17305/bjbms.2008.2996 ◽

2008 ◽

Vol 8 (1) ◽

pp. 44-47 ◽

Cited By ~ 11

Author(s):

Zulfo Godinjak ◽

Edin Idrizbegović

Keyword(s):

Diagnostic Laparoscopy ◽

Diagnostic Tools ◽

Routine Procedure ◽

Endometrial Polyps ◽

Septate Uterus ◽

Infertile Women ◽

Uterine Anomalies ◽

Diagnostic Hysteroscopy ◽

Infertile Patients

The aim of this study was to clarify the role of simultaneous combined diagnostic approach using laparoscopy and hysteroscopy in the evaluation of female infertility.In a retrospective study, 360 infertile women underwent complete fertility evaluation. All the patients were examined by simultaneous combined laparoscopy and hysteroscopy as a part of the routine infertility evaluation.Laparoscopy and hysteroscopy were successful in 360 patients. Bilateral tubes were blocked in 18 (5%) and unilateral tubal occlusion were in 30 (8,33%) of patients. Pelvic adhesions were revealed in 40 (11,11%), and myomas in 42 (11,65%) out of that 31 (8,6%) were revealed by laparoscopy and 11 (3,05%) by hysteroscopy. Endometrial polyps were revealed in 26 (7,22%) and Syndrome Asherman in 3(0,83%) of patients. Uterine anomaly was found in 19 (5,27%) of cases and out of that septate uterus in 7 (37,15%), bicornuate uterus in 5 (26,31%), arcuate uterus in 4 (21,26%) and uterus unicornu cum cornu rudimentario in 3 (15,27%) of uterine anomalies. Endometriosis was found in 51 (14,16%), dermoid cysts in 8 (2,22%) and in 16 (4,44%) functional cysts of patients. Also, Fitz-Hugh- Curtis syndrome was revealed in 23 (6,11%) of our patients.Laparoscopy and hysteroscopy play very important role as diagnostic tools in the infertility women. Combined diagnostic simultaneous laparoscopy and hysteroscopy should be performed in all infertile patients before the treatment.

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Role of Four Layer Compression Dressings in Management of Chronic Venous Ulcers

International Journal of Recent Surgical and Medical Sciences ◽

10.1055/s-0040-1708222 ◽

2019 ◽

Vol 5 (02) ◽

pp. 42-45

Author(s):

Luv Luthra ◽

Rajendra Prasad ◽

Ranjith Kumar ◽

Nivedita Mitta ◽

Tinku Varghese

Keyword(s):

Lower Extremity ◽

Healing Rate ◽

Randomized Study ◽

Compression Therapy ◽

High Morbidity ◽

Age Group ◽

Duration Of Treatment ◽

Medical College ◽

Venous Ulcers

Abstract Introduction Nonhealing venous ulcers are one of the most common forms of lower extremity ulcers in the present population. It is cumbersome to treat and is associated with high-morbidity and immense treatment expenses. The current treatments include compression therapy. Four-layer compression dressings have proven to be an effective treatment for venous ulcers. Objective This study aimed to evaluate the efficacy of four-layer compression dressings and to study the rate of healing and duration of treatment with four-layer compression dressings. Materials and Methods A prospective randomized study conducted at MS Ramaiah Medical college which included 70 patients who completed the course of weekly dressings depending on the size of ulcer. The regular four-layer dressings were done by a trained podiatrist in vascular outpatient department (OPD) once a week. The area of the ulcer was calculated using the modified Gilmen formula. Results A total of 70 patients who were compliant with the treatment were included in the study. A considerable percentage (74%) of patients were male and all the ulcers were located at the gaiter area. Most belonged to the age group between 41 to 50 years (25%). The healing rate of ulcers at the end of 4, 8 and 12 weeks were 46.87, 28.12, and 25%, respectively. At the end of 12 weeks, all the ulcers healed.

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