Laparoscopy in Infertility: Uncovering the Pelvic Pathology

and postpartum infections, and tuberculosis, if left untreated, contribute majorly to infertility in developing countries.10,11 Various abnormalities that are often missed by routine pelvic examination and usual imaging procedures, such as peritoneal endometriosis, adnexal adhesions, and structural abnormalities of the pelvis, tubes, and uterus, can be easily detected on diagnostic laparoscopy in patients who have normal ovulation and IntroductIonInfertility is defined as the inability of a couple to conceive after 1 year of unprotected intercourse of reasonable frequency, affecting around 10-15% of couples throughout the world. 1 Tubal, ovulatory, uterine, or cervical factors, and male factor infertility account for the primary causes of infertility.2,3 According to the World Health Organization (WHO), the majority of cases of tubal blockage are due to malnutrition, pelvic tuberculosis, and puerperal infections.4 Laparoscopy has become a primary step in the workup and evaluation of infertile patients before starting infertility treatment.5 It provides an outstanding means, through direct visualization of the pelvis, to interpret hidden pathology where there is an absence of clinical signs and symptoms, thereby providing greater information compared to hysterosalpingography and ultrasonography.6 It is the most appropriate method to investigate pelvic pathology.It provides information relating to tubo-ovarian status, uterine normality, and various pelvic pathologies, such as pelvic inflammatory disease, pelvic congestion syndrome, and tuberculosis.7,8 In many cases of infertility, despite normal hysterosalpingography, laparoscopy revealed certain abnormal findings.9 Hence, laparoscopic findings could change the plan of treatment in a large number of infertile patients (like IUI or IVF) with normal hysterosalpingography.Pelvic inflammatory disease, postabortal