Role of hysteroscopy and laparoscopy in evaluation of unexplained infertility

MohamedS Gad, RagabM Dawood, MohamedS Antar, ShaimaaE M Ali
In: Menoufia Medical Journal · 2019 · vol. 32(4) , pp. 1401 · doi:10.4103/mmj.mmj_387_18 · W2998673182
article OA: closed CC0 ⤵ 3 in-corpus citations
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This observational study on 200 women with unexplained infertility found hysteroscopy and laparoscopy to be reliable for comprehensive evaluation, detecting uterine septum, adnexal adhesions, endometriosis, and tubal blocks.

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Abstract

ObjectiveTo evaluate the diagnostic and therapeutic role of combined hysterolaparoscopy in female infertility.BackgroundInfertility affects approximately 10–15% of reproductive age couples. Causes of infertility in the female partner include ovulatory, tubal, uterine, cervical, and endometriosis. Owing to its noninvasive nature and low cost, hysterosalpingography (HSG) is widely used as a first-line approach to assess the patency of the fallopian tubes and uterine anomalies. We assessed hysterolaparoscopy as a one-step procedure and compared it with HSG, in the ovulatory infertile women with normal pelvic sonography, seminogram, hormonal assays, and HSG. Even in women thought to be at low risk for significant pelvic pathology affecting reproduction, the yield was high. Laparoscopy was helpful in making a decision to go to assisted reproductive technology.Patients and methodsAn observational cross-sectional study conducted on 200 women aged 20–40 years old with unexplained infertility. Methylene blue test, inspection for abnormal pelvic and intrauterine pathology, and therapeutic interventions when needed were done.ResultsOf 200 patients, 116 had primary and 84 had secondary infertility. The patients in the secondary infertility group were older compared with the primary group. The most common intrauterine pathology was uterine septum. Adnexal adhesions and endometriosis were the most common abnormalities detected in laparoscopy. The prevalence of endometriosis and unilateral tubal block was higher in the primary group. The operative interventions, both hysteroscopic and laparoscopic, were also recorded.ConclusionHysterolaparoscopy is a reliable method in comprehensive evaluation of infertility.

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endometriosisinfertility

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