title: [Interest of laparoscopy in infertile couple with normal hysterosalpingography].
abstract: OBJECTIVE
  The diagnostic laparoscopy has long been the key consideration in the export of female infertility. This place is being reconsidered, especially in the case of normal hysterosalpingogrophy (HSG), because of the advent of assisted reproductive technologies which are more efficient, and because of the improvement of medical imaging techniques which are more sensitive and specific. We wanted to clarify the place of the diagnostic laparoscopy in the balance of female infertility in normal HSG.
  
  
  METHODS
  It is a retrospective study on a series of 100 observations of infertile patients with a normal HSG and having a diagnostic laparoscopy in the department of Gynecology and Obstetrics at Farhat Hached hospital in Sousse (Tunisia) from 1st January 1993 to 1st March 2003.
  
  
  RESULTS
  The mean age was 32.3years; the mean duration of infertility was 70.47months. Laparoscopy revealed pelvic abnormalities in 45% of cases, dominated by disease tubo-adhesions (23%), endometriosis was found in 6% of cases. These anomalies are considered major in 23% of cases and minor in 22% of cases. Conducting a surgical procedure in the same operating time (adhesiolysis, tubal plastic surgery, electrocoagulation of endometriosis implants) could improve the prognosis of fertility. Only 20 patients were followed among the 45 with pelvic abnormalities, seven pregnancies have been completed (35% of cases).
  
  
  CONCLUSIONS
  Laparoscopy has improved the prognosis for the fertility of our patients by treating abnormalities involved in infertility. It is estimated that the prognosis can be improved by selecting patients with risk factors for pelvic abnormalities.
authors: Service de gynécologie-obstétrique, hôpital Ibn Jazzar, Kairouan, Tunisie. Electronic address: ridha.fatnassimohamed@rns.tn.
authors: R
authors: R
authors: Fatnassi
authors: Centre de maternité, CHU Farhat Hached, Sousse, Tunisie.
authors: O
authors: O
authors: Kaabia
authors: Service de gynécologie-obstétrique, hôpital Ibn Jazzar, Kairouan, Tunisie.
authors: S
authors: S
authors: Laadhari
authors: Centre de maternité, CHU Farhat Hached, Sousse, Tunisie.
authors: R
authors: R
authors: Briki
authors: Service de gynécologie-obstétrique, hôpital Ibn Jazzar, Kairouan, Tunisie.
authors: Z
authors: Z
authors: Dimassi
authors: Centre de maternité, CHU Farhat Hached, Sousse, Tunisie.
authors: M
authors: M
authors: Bibi
authors: Centre de maternité, CHU Farhat Hached, Sousse, Tunisie.
authors: S
authors: S
authors: Hidar
authors: Centre de maternité, CHU Farhat Hached, Sousse, Tunisie.
authors: L
authors: L
authors: Ben Regaya
authors: Centre de maternité, CHU Farhat Hached, Sousse, Tunisie.
authors: H
authors: H
authors: Khairi
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D005184:Fallopian Tube Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D007047:Hysterosalpingography; D007247:Infertility, Female / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D010535:Laparoscopy; D008875:Middle Aged; D011247:Pregnancy; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome; D014416:Tunisia; D055815:Young Adult
keywords: Cœlioscopie; EndOmetriosis; Endométriose; Hysterography; Hystérographie; Infertility; Infertilité; Laparoscopy; Obstruction tubaire; Tubal blockage