Laparoscopic Diagnosis Of Unexplained Infertility:A Systematic Review

Objective: To explore the diagnostic value of laparoscopy to unexplained infertility by systematic review,to evaluate the effectiveness of laparoscopy for diagnosis of unexplained infertility and compared with other diagnostic methods.Methods: Literatures published on PubMed,Cochrane Library,Wed of Science,CKNI,WANFANG DATA and CBM were searched based on the established strategy.Accordance with the inclusion criteria and exclusion criteria strictly,quality of included studies was assessed,the analysis of heterogeinety between the included studies was performed.ORs and their 95%CI were used to assess the strength of association between laparoscopy and pregnancy rate.RevMan 5.3 was used to analyze the data.Results: A total of 13 studies were included in this study.There were 2104 cases of unexplained infertility patients performed laparoscopy.There were 1354 cases of pelvic abnormalities and 750 cases of normal pelvis.Among them,pelvic abnormalities were mainly endometriosis,a total of 789 cases,and followed by pelvic adhesions,tubal factors,pelvic tuberculosis,polycystic ovary,ovarian cysts,uterine fibroids,etc.There were 10 studies research the postoperative pregnancy rate,the pregnancy rate was in the range of 45.8%-75.5%,an average of about 60%,and there were 3 studies didn't research the pregnancy outcome.Three studies for clinical control trials were included for meta-analysis and our meta-analysis suggests there were no significant differences between laparoscopy and pregnancy rates,OR = 1.39,95% CI = [0.69,2.83],P = 0.36,I2 = 86%.There is considerable heterogeneity among the study variables,suggesting that results with low confidence,the data cannot be merged.Conclusions: Laparoscopy can be discovered the hidden pelvic abnormalities of unexplained infertility patients more accurately and deal with it in time.It can remove pelvic factors that may affect pregnancy.It has definite diagnostic value and appropriate therapeutic value,It provides an important basis for the diagnosis and therapy for unexplained infertility patients in the future.