Resumen

PAVLOVIC B, Milenko; MANZUR Y, Alejandro  y  MACAYA P, Rodrigo. Rol de la laparoscopia en la infertilidad inexplicada: Experiencia del Hospital Clínico de la Pontificia Universidad Católica de Chile. Rev. chil. obstet. ginecol. [online]. 2012, vol.77, n.5, pp.367-374. ISSN 0717-7526.  http://dx.doi.org/10.4067/S0717-75262012000500007.

Background: There is an increased global tendency for avoiding a diagnostic laparoscopic surgery, among patients with unexplained infertility and a normal histerosalpingography. This decision may have certain consequences, as there may be undiagnosed lesions, such as tuboperitoneal ones, which could have an impact in the management of these patients. Our group treats them with diagnostic therapeutic laparoscopy, followed by three cycles of intrauterine insemination. Objectives: Validate our management of unexplained infertility, estimate the frequency of pelvic pathology in patients with unexplained infertility with a normal histerosalpingography, evaluate the pregnancy rate after the laparoscopic resolution of their pathology, and review the existent literature. Results: We reviewed all laparoscopic surgeries performed in patients with unexplained infertility in Hospital Clínico de la Pontificia Universidad Católica, between 2007-2011. From these, 57 patients met the inclusion criteria, and 39 of them received at least one intrauterine insemination cycle after the procedure. Laparoscopic alterations were present in 82.4% of the patients, being the most prevalent ones endometriosis grade I and II (57.8%) and pelvic adhesions (43.8%). Of the 57 patients who underwent laparoscopy, only 25 completed three cycles of intrauterine insemination, 8 of which conceived (32%). Conclusion: Our results are similar to those exposed in other series, regarding pathologic findings and fertility rate after laparoscopy. As there is limited access to advanced reproductive techniques in our country, our management represents an excellent choice for this group of patients.

Palabras clave : Unexplained infertility; diagnostic laparoscopy; endometriosis; intrauterine insemination; hysterosalpingography.

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