Title: Laparotomy for female infertility.

POPLINE Document Number: 018215

Author(s):

Kaur T
Debdas AK

Source citation:

Journal of the Indian Medical Association, 1980 May 1;74(9):165-8.

Abstract:

Laparotomy continues to be the only method available in India for dealing with female infertility. 45 consecutive cases of laparotomy for infertility were collected from among the new and follow-up patients who attended the Gynecological and Antenatal Clinic of Telco Maternity Hospital, Jamshedpur, India over the January 1977 to April 1979 period. Neither human pituitary gonadotropin nor ergobromocryptine were used in this unit. Only clomiphene citrate was used for treatment of infrequent ovulation. None of the patients had prior laparoscopy. All patients taken for laparotomy had transcervical dye test and transuterine injection of saline to check the tubal patency. All patients had healthy husbands. The proportion of primary and secondary infertility in this series was 62.22% and 37.77%, respectively. The single major indication for laparotomy was bilaterally blocked tubes on hysterosalpingogram which was present in 20 cases. Among other indications infrequent ovulation (with or without bilaterally enlarged ovaries) was present in 10 (22.2%) cases. All the 10 patients had clomiphene citrate in the usual regimen for 3 consecutive cycles in increasing doses up to 150 mg a day but without success. In terms of laparotomy findings, in no case was there any evidence of tuberculosis or pelvic endometriosis (apart from the case who had chocolate cyst). In all the 3 cases where the only abnormality was peritubal adhesions preoperative hysterosalpingograms were normal and in all of them laparotomy was performed as a final method of investigation. Of the 12 cases who showed bilateral cornual block in preoperative hysterosalpingogram, tubal patency tests at laparotomy showed unilateral blockage in 4 and no blockage at all in another 4. Of the 13 cases where no lesion was found, the indication of laparotomy was bilateral cornual block (4 cases) and in 9 cases it was performed simply as a method of investigation. In 10 of the 45 cases, the ovaries appeared to be like those found in Stein Leventhal syndrome.

Keywords:

Laparotomy
Infertility
Examinations and Diagnoses
Treatment
Laboratory Examinations and Diagnoses
Women
Pregnancy
Surgery
Reproduction
Demographic Factors
Population