Is diagnostic laparoscopy absolutely indicated in infertility?
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Hysterosalpingography (HSG) is a basic diagnostic procedure in infertility. In recent years diagnostic laparoscopy has become popular and used in almost every infertile patient. However nowadays agreement on this approach is not so clear. In our clinic, between years of 2004-2006 we have evaluated the result of diagnostic laparoscopy of 121 infertile women who had HSG formerly. We classified the cases according to HSG results. 68 cases in the first group the HSG results was normal. In the second group with 16 cases there was unilateral tubal obstruction. In the third group with 37 cases obstruction was bilateral. Diagnostic laparoscopy and HSG results of 1. and 2. group revealed similarity. In contrast no abnormality was observed in 14 cases of the 3. group. HSG is the first line procedure while evaluating tubal alone patency. However regarding peritubal adhesions alone it has of no value. In the case of bilateral tubal obstruction determined in HSG, diagnostic laparoscopy is absolutely indicated.