Laparoscopy should be strongly considered for women with unexplained infertility.
OBJECTIVE
Women with unexplained infertility frequently become pregnant after diagnostic laparoscopy. In this study the effect of laparoscopic surgery on such women was evaluated by the pregnancy rate after laparoscopic surgery.


METHODS
A total of 47 unexplained infertile women underwent laparoscopic evaluation during the period August 2002 to January 2005 in our center. The percentage of positive laparoscopic findings and the pregnancy rate after laparoscopy were calculated. The patients were divided into 5 subgroups according to maternal age, pregnancy rates were calculated for each group, and compared with the outcome of assisted reproductive technology (ART) treatment for the same age groups.


RESULTS
In 87.2% of the women, laparoscopy revealed abnormal findings; endometriosis lesions, peritubal adhesions and tubal obstructions were found in 21, 17 and 3 cases, respectively. After laparoscopy 23 achieved pregnancy (pregnancy rate: 48.9%). The pregnancy rates of the groups at the age of 25 years old or less, 26-30, 31-35, 36-40 and over 41 years old were 100%, 75.0%, 45.5%, 27.2% and 0%, respectively. In the case of the 26-30 years old group, the pregnancy rate after laparoscopy was significantly higher than that in the ART treatment group (33.3%, P < 0.05).


CONCLUSIONS
Laparoscopy should be strongly considered for examining women with unexplained infertility.
Nakagawa
Koji
K
Division of Reproductive Medicine, Department of Perinatal Medicine and Maternal Care, National Center for Child Health and Development, Tokyo, Japan. nakagawa-kj@ncchd.go.jp
Ohgi
Shirei
S
Horikawa
Takashi
T
Kojima
Rieko
R
Ito
Megumu
M
Saito
Hidekazu
H
D000328:Adult; D005260:Female; D005307:Fertilization in Vitro; D005831:Genital Diseases, Female / Q000175:diagnosis / Q000601:surgery; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D008297:Male; D011247:Pregnancy