Clinical Study On Diagnosis And Treatment Of Unexplained Infertility By Combined Hysteroscopy And Laparoscopy

Objective:To explore the importance of the diagnosis and treatment value of laparoscopy and hysteroscopy in patients with unexplained infertility.Methods:A total of 519 cases diagnosed as unexplained infertility,received laparoscopy and hysteroscopy in Peking Union Medical College Hospital from May 2012 to December 2015.The causes of infertility were evaluated,and the subjects were followed up to observe the nature pregnancy rate.Results:Among 519 infertile patients,10.2%(53/519)did not find abnormalities by combined hysteroscopy and laparoscopy,and 89.8%(466/519)found pelvic abnormalities,which accounted for 72.4%(376/519)of endometriosis complicated with adhesions,respectively,According to the R-AFS stage,137 cases(36.4%)were in stage I(micro focus),148 cases(mild focus),39.3%,64 cases(moderate focus),17.0%,27 cases(severe focus),7.1%.According to EFI score,0-4 scores accounted for 26(6.9%),5-7 scores accounted for 183(48.7%)and 8-10 scores accounted for 167(44.4%).Pelvic inflammatory disease with adhesions was 12.3%(64/519),uterine fibroids or ovarian cysts were 3.7%(19/519)and endometrial polyps were 1.3%(7/519).The total pregnancy rate within the 3 years of follow up was 53.89%(208/386)and the natural pregnancy rate was 29.8%(31/104)in patients over 35 years old.Conclusion:Patients with clinically diagnosed unexplained infertility should undergo hysteroscopy and laparoscopy examination.The cause of infertility can be found more intuitively,and targeted treatment can be carried out under the mirror Compared with those under 35 years of age,low nature pregnancy rate was observed in the advanced age group.It is suggested that older patients should reduce the time of expectation after surgery.