The Utility of Diagnostic Laparoscopy for Assessing Complex Infertility Cases: A Cross-Sectional Study on Uterine, Ovarian, and Unexplained Factors

Background: Infertility affects a substantial percentage of couples globally, with complex cases often involving uterine, ovarian, or unexplained factors that remain challenging to diagnose accurately. Although non-invasive imaging methods such as ultrasound and hysterosalpingography (HSG) are widely used, their limitations in sensitivity and specificity underscore the need for diagnostic laparoscopy, a minimally invasive procedure with high diagnostic accuracy. This study aims to evaluate the utility of diagnostic laparoscopy in assessing complex infertility cases, specifically focusing on uterine, ovarian, and unexplained factors. Methods: A cross-sectional study was conducted on 50 women presenting with either primary or secondary infertility. Each participant underwent diagnostic laparoscopy following standard clinical assessments, including ultrasonography and hormonal profiling. Data were collected on uterine anomalies, ovarian cysts, PCOD, and unexplained infertility cases, and were analyzed to compare findings between primary and secondary infertility groups. Results: Uterine abnormalities, primarily fibroids, were identified in 12% of cases, mainly among primary infertility patients. Ovarian factors, including PCOD and ovarian cysts, were detected in 20% of cases across both primary and secondary infertility groups. Additionally, 12% of cases were classified as unexplained infertility due to the absence of identifiable abnormalities. Diagnostic laparoscopy provided higher detection rates for these factors compared to conventional imaging techniques, underscoring its role in cases where non-invasive methods were inconclusive. Conclusion: Diagnostic laparoscopy is a valuable tool for identifying complex infertility factors, offering a reliable and safe method for comprehensive infertility evaluation. Its high diagnostic accuracy, particularly for detecting uterine, ovarian, and unexplained infertility factors, supports its use as a routine investigative procedure in infertility workups. Recommendations: Laparoscopy should be considered for routine use in infertility evaluations, especially for patients with complex or unexplained infertility, to improve diagnosis and guide targeted treatment.