Three methods have been used in the present
study as the measures to assess tubal status. These
include hysterosalpingography (HSG), laparoscopy
and the combination of both methods. Several studies
demonstrated that HSG is a good screening test for
tubal occlusion although it has some limitations in
evaluating extra-luminal pathology such as pelvic
adhesion distant from the fallopian tubes or pelvic
endometriosis(5). The advantage of laparoscopy
presented in the present study is that this method
provides the physician the opportunity to thoroughly
evaluate tubal status as well as other pelvic structures.
The data from the present study revealed a high
prevalence (87.50%) of extra-tubal pelvic pathologies.
Endometriosis was the disease most commonly
detected by laparoscopy (61.49% of cases underwent laparoscopic procedures). Other conditions such as
pelvic adhesions and myoma uteri were found in
more than one-third of the cases. These pathologies,
to some extent, can attribute to the reduction in
fertility potentials of the patients and hence proper
management after correct diagnosis being established
is needed to improve the prognosis of such cases.
Based on the results of the present study, the authors,
therefore propose that laparoscopy should be considered
as part of female infertility investigation since
it is helpful in revealing extra-tubal pathologies that
seem to occur quite commonly in such patients.