Second-look laparoscopy in infertility surgery: therapeutic and prognostic value.

Sixty infertile women underwent infertility surgery followed by "second-look laparoscopy" (SLL). All these women had undergone detailed fertility workups, including a diagnostic laparoscopy prior to surgery. The tuboovarian adhesive disease was staged according to the severity of the disease and compared with findings at SLL. Sixty percent of adnexa showed improvement at SLL. During SLL, newly formed adhesions were lysed and stenotic fimbrial ostia dilated. Optimal time for SLL was 4 to 8 weeks after surgery. From these observations, we suggest that SLL provides further opportunity to lyse re-formed adhesions and may have prognostic and therapeutic benefits after laparotomy for lysis of adhesions.