Unexplained Infertility Treated by Hysteroscopy-laparoscopy

Study Overview
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Brief Summary
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Retrospective study, including patients from january 2013 to december 2018, who were diagnosed with unexplained infertility : spontaneously ovulating women with normal pelvic ultrasound scan, patent tubes on hysterosalpingography and normal pelvic exam or pelvic MRI normal. Semen analyses were normal according to the World Health Organization criteria. Couples were referred for diagnostic laparoscopy and hysteroscopy. They were then addressed for spontaneous fertility or ART to conceive. The investigators would like to see how many surgeries were useful to assess a diagnostic, and if operating allows a satisfying pregnancy rate. The investigators would like to assess how many diagnosis was done after surgery and how many pregnancy were obtained. The investigators search other prognostic factors than age or parity.

Official Title
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Unexplained Infertility Treated by Hysteroscopy-laparoscopy : Predictive Factors of Pregnancy

Conditions
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Unexplained Infertility

Intervention / Treatment
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* Procedure: Laparoscopy-hysteroscopy


Participation Criteria
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Eligibility Criteria
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Inclusion criteria: 18-43y unexplained infertility operated from laparoscopy-hysteroscopy at montpellier university hospital Exclusion criteria: an IMR that diagnoses formelly an endometriosis, or endometriosic ovarian cysts any non respect to inclusion criterias non respect of our definition of unexplained infertility (such as bilateral tubal issue on hysterosalpingograms)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 43 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Unique cohort<br>All women, 18 to 43 years, operated from laparoscopy-hysteroscopy for unexplained infertility in montpellier university hospital | Procedure: Laparoscopy-hysteroscopy<br>* Under general anesthesia, we start by a first look in laparoscopy, to look for endometriosis mainly, tubal infertility, ovarian cysts or any abnormalities that may not have been suspected on the first exam. Then we check tubal patency after a look at the uterine cavity by hysteroscopy. Then we treat everything possible to treat to improve fertility, spontaneous or with ART.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| clinical pregnancy rate | pregnancy with an hearbeat on a pelvic ultrasound scan | 1 day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants with miscarriage | Number of Participants with miscarriage : positive pregnancy blood test, resulting in bleeding | 1 day | 
| live birth rate | live birth rate : birth of a viable foetus after 24 SA | 1 day | 
| Number of Participants with fœtal losses | Number of Participants with Foetal losses : loss of a non viable foetus, before 24 SA | 1 day | 
| Number of Participants with ectopic pregnancy | Number of Participants with ectopic pregnancy: tubal pregnancy highly suspected by blood test or seen on a pelvic ultrasound scan | 1 day | 
| Number of Participants with surgical complications | Number of Participants withSurgical complications : during surgery, and a few days after surgery | 1 day | 
| Number of Participants with type of surgery | Number of Participants with type of surgery: tubal surgeries, adhesiolysis, endometriosis surgeries, hysteroscopic gestures. | 1 day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Ovulation, semen analysis, tubal patency, pelvic ultrasound scan