Frequency of Causes of Female Infertility Diagnosed Through Laparoscopy in Females Presenting in a Tertiary Care Hospital

  • Mahwish Saif cpsp
  • Sadia Mustafa
  • Binyamin Butt
Keywords: Infertility, Laparoscopy, Endometriosis, Fibroid, Hysterosalpingography, Polycystic ovarian disease


To report the frequency of causes of female infertility by laparoscopy in females presenting in a tertiary care hospital
Study design: Cross sectional study
Setting: Department of Obstetrics & Gynecology, Shalimar Hospital, Lahore
Duration of study: July 01, 2020, till July 31, 2021
A total of 370 females fulfilling selection criteria were selected from operation theatre of Department of Obstetrics and Gynecology, Shalimar Hospital Lahore. Informed consent was obtained from each case. Demographic information (name, age, BMI, duration of marriage, type of infertility, and parity) will also be noted. Then females underwent laparoscopy under general anesthesia by researchers. On laparoscopy, the pelvis was inspected, including uterus, fallopian tubes, round ligaments, uterovesical pouch, uterosacral ligaments, and Pouch of Douglas. The tubes were inspected for any abnormality in their length and shape and patency was checked by retrograde dye test. Both ovaries were examined regarding their size, shape, thickness of peripheral follicles, evidence of ovulation and their relationship with fimbrial end of the tubes. Peritubal, periovarian and omental adhesions, tubo-ovarian masses, endometriotic deposits, fibroid, presence of fluid in the Pouch of Douglas or any other pathology, if present was noted. Data was entered and analyzed in SPSS version 21.0.
The mean age of our cases was 33.93 ± 5.81 years with minimum and maximum ages of 18 and 45 years. According to the etiology of infertility, 5(1.4%) cases had unexplained infertility, 140(37.8%) cases had tubal infertility, 60(16.2%) cases had polycystic ovaries, 41(11.1%) cases had Peritubal and peri-ovarian adhesion, 71(19.2%) cases had endometriosis, 38(10.3%) females had fibroids and 20(5.4%) cases had an ovarian cyst.
We conclude that on diagnostic laparoscopy the frequency of causes of female infertility was found to be tubal infertility (37.8%), followed by endometriosis (19.2%), polycystic ovaries (16.2%), Peri-tubal and peri-ovarian adhesion (11.1%), fibroids (10.3%), ovarian cyst (5.4%), unexplained infertility (1.4%).


1. Infertility Workup for the Women's Health Specialist: ACOG Committee Opinion, Number 781. Obstet Gynecol. 2019 Jun;133(6):e377-e384. [PubMed]
2. World Health Organization (WHO). International Classification of Diseases, 11th Revision (ICD-11) Geneva: WHO 2018.
3. Nayak PK, Mahapatra PC, Mallick J, Swain S, Mitra S, Sahoo J. Role of diagnostic hysterolaparoscopy in the evaluation of infertility: A retrospective study of 300 patients. Journal of human reproductive sciences 2016;6(1):32.
4. Pundir J, El Toukhy T. Uterine cavity assessment prior to IVF. Women's Health 2015;6(6):841-8.
5. Jacob Farhi M. Distribution of causes of infertility in patients attending primary fertility clinics in Israel. IMAJ Jan 2015;13:51-4.
6. Boricha Y, Sharma R. Laparoscopy in 50 infertile couples: prospective study. 2014.
7. Haider G, Rani S, Talpur S, Zehra N, Munir A. Laparoscopic evaluation of female infertility. J Ayub Med Coll Abbottabad 2014;22(1):136-38.
8. Pegu B, Gaur BPS, Sharma N, Singh A. Laparoscopic evaluation of female infertility. International Journal of Medical and Health Sciences 2016;3(3):172-6.
9. Shamim S, Farooq M, Shamim R. Diagnostic laparoscopic findings in infertile patients in the Saudi population. Pakistan J of Medical and Health Sciences 2016;4(4):560-63.
10. Aziz N. Laparoscopic evaluation of female factors in infertility. J Coll Physicians Surg Pak 2014;20(10):649-52.
11. Jain G, Khatuja R, Juneja A, Mehta S. Laparoscopy: as a first line diagnostic tool for infertility evaluation. Journal of Clinical Diagnostic Research 2014;8(10).
12. Neelofar S, Tazeen S, editors. The cultural politics of gender for infertile women in Karachi, Pakistan. Gender Studies Conference; 2015.
13. Evers JL, Collins JA. Assessment of efficacy of varicocele repair for male subfertility: a systematic review. Lancet 2013;361(9372):1849-52.
14. Lunenfeld B, Van Steirteghem A. Infertility in the third millennium: implications for the individual, family and society: condensed meeting report from the Bertarelli Foundation's second global conference. Hum Reprod Update 2014;10(4):317-26.
15. Eniola OW, Adetola AA, Abayomi BT. A review of Female Infertility; important etiological factors and management. J Microbiol Biotech Res 2017;2(3):379-85.
16. Esimai O, Orji E, Lasisi A. Male contribution to infertility in Ile-Ife, Nigeria. Nigerian J Med 2017;11(2):70-2.
17. Rutstein SO, Shah IH. Infecundity infertility and childlessness in developing countries. 2016.
How to Cite
Saif M, Mustafa S, Butt B. Frequency of Causes of Female Infertility Diagnosed Through Laparoscopy in Females Presenting in a Tertiary Care Hospital. JRMC [Internet]. 31Mar.2022 [cited 27May2022];26(1):112-6. Available from: