Application Study Of The Laparoscope In The Diagnosis And Treatment Of Female Infertility

Objective To discuss the value of the laparoscope in the diagnosis and treatment of female infertility and evaluate the ovarian reserve function change after the laparoscopic operationMethod Retrospective Analysis of 367 female infertile patients who underwent laparoscopic operation in our hospital during Jau.2006 and Jun.2009, do an follow up about their pregnancy rate and ovarian reserve function changes.In these cases, the bilateral hydrosalpinx patients were divided into three groups according to the different operation methods. Group A:bilateral salpingostomy (18cases). Group B:ligation the proximal end of bilateral salpinx and embedding of the distal end (23cases). Group C:bilateral salpingectomy with Core-pulling method (19cases). Observe the patients'basic serum estradiol(E2), follicule-stimulating hormone (FSH) before the operation and in the first and third menstrual cycle after the operation. Some other cases with pelvic adhesion were also divided into three groups according to the pelvic adhesion degree. Group A:mile pelvic adhesion (70cases) Group B:moderate pelvic adhesion (52cases). Group C:severe pelvic adhesion (43cases). The same method to observe the patients'basic serum estradiol(E2), follicule-stimulating hormone (FSH) value.Result:â‘ The 367 cases who underwent laparoscopic operation were be found out pelvic organic disease in 340 cases, the positive rate is 92.92%. The pelvic adhesion, salpinx infertile and pelvic endometriosis are the most common diseases. In primarily infertility, pelvic endometriosis is the most important cause while pelvic adhesion in secondary infertility.â‘¡By telephone follow up after operation,224 patients have be pregnant, the rate is 62.22%.â‘¢There is no statistic significance between bilateral salpingostomy group and proximal end ligation distal end embedding group of their E2,FSH value before and after the operation(P>0.05). In the bilateral salpingectomy with Core-pulling method group, the differences of FSH value in the first post-operation menstrual cycle has statistic significance compare to the pre-operation value (p<0.05), but no differences in the third cycle(p>0.05).â‘£The FSH and E2 value in patients with mile and moderate pelvic adhesion has statistic significance compare to the severe pelvic adhesion patients before operation (p<0.05). The FSH and E2 value in patients with mile and moderate pelvic adhesion has no statistic significance before and after the operation (p>0.05). The FSH and E2 value in patients with severe pelvic adhesion in first and third post-operation menstrual cycle both have statistic significance compare to before operation (p<0.05),but no statistic significance between first and third menstrual cycle after operation (p>0.05). There is no statistic significance of the FSH and E2 value in the first post-operation menstrual cycle among any two groups (p>0.05), the same with the third post-operation menstrual cycle.Conclusion:â‘ Use the laparoscope is able to find out the cause of the infertility early, rightly and directly,then do an directly treatment, increase the pregnancy rate.â‘¡laparoscopic bilateral salpingectomy with Core-pulling method will affect the ovarian reserve function in a short time. Laparoscopic bilateral salpingostomy and proximal end ligation distal end embedding method have no obvious affect to the ovarian reserve function.â‘¢The ovarian reserve function in patients with severe pelvic adhesion can be improved after laparoscopic operation.