Abstract:

Aim: To analyze the laparoscopic findings in infertile cases retrospectively and to classify the detected pelvic pathologies, to according to classification of American Fertility Society, to compare the diagnostic values of laparoscopy and hysterosalpingography in infertile cases. Material and Method: In this study, results of 65 infertile females who underwent laparascopy in our department between January 2004 to June 2008 were analyzed retrospectively. Pelvic adhesions and endometriosis cases were classified according to American Fertility Association classification and distribution ratios in primary and secondary infertile cases were detected. Patients were grouped according to radiocontrast medium passage from fallopian tubes in hysterosalpingography and methylene blue passage in laparoscopy and additionally according to morphologic pathologhies in laparascopy and results were compared. Findings: Of the cases, normal genital findings were detected in 32.30%, tubal pathology was detected in 29,23%, ovarian pathology was detected in 3,07%, uterin pathology was detected in 26,15%, endometriosis was detected in 10,76%. Pelvic adhesions were detected in 27,66% of patients having tubal, ovarian pathologies and endometriosis concurrently.. Total adnexial adhesion number was 17. Adnexial adhesions were detected in 13 of 47 primary infertility cases (27,65%) and in 4 of 18 secondary infertility cases (22,22%). Ratio of minimal and mild adhesions was 41,17%, ratio of moderate and severe adhesions was 58,82% and vast majority of these adhesions were detected in primary infertility cases. Minimal endometriosis was detected in five of seven endometriosis cases, moderate endometriosis was detected in one and severe endometriosis was detected in one of the cases. Endometriosis was detected in five of primary endometriosis cases and in two of secondary endometriosis cases. While positive predictive value of hysterosalpingography in detection of morphologic pathology in tubes was 83,6% (71,2-92,2), negative predictive value was detected as 89,3% (80,1-95,3). Additionally, positive predictive valueof hysterosalpingography for detection of tubal passage was detected as 99% (94,3-100) and negative predictive value was detected as 61,8% (43,3-78,1). Hysterosalpingography and Laparoscopy was found to be consistent with each other in detection of pathology in tubal morphology and tubal passage (p=0,000 ve p=0,000). Conclusion: In diagnostic area of female infertility, hysterosalpingography and Laparoscopy have similar suces rate in detection of tubal morphology and tubal patency.

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