Should diagnostic laparoscopy be performed initially or not, during infertility management of primary and secondary infertile women? A cross-sectional study

The debate about the timing of diagnostic laparoscopy in unexplained infertile women has been investigated in this prospective study. A total of 328 infertile women who underwent diagnostic laparoscopy for investigation of infertility at any stage of their infertility management from April 2001 to April 2003 were investigated. When the study group was resized according to the inclusion criteria 191 unexplained infertile patients were included. Preoperative and postoperative treatment strategies were compared. The correlation between hysterosalpingography and laparoscopy findings was identified. The results were evaluated using SPSS version 10.0 for Windows. A total of 106 patients were primary and 85 were secondary infertile. The mean ages of primary and secondary infertile patients were 27 +/- 5 and 29 +/- 5, respectively. Sixty percent of primary and 69% of secondary infertile patients had pelvic pathologies. Treatment strategies of 29 (43%) primary infertile and 27 (49%) secondary infertile patients with infertility-related risk factors changed after diagnostic laparoscopy. Diagnostic laparoscopy in preparation for operative procedures (especially for secondary infertile women) should be performed initially in all unexplained infertile patients with or without risk factors related to pelvic pathologies.