A prospective study to evaluate the role of hysterolaparoscopy in infertility

In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2018 · vol. 7(9) , pp. 3852 · doi:10.18203/2320-1770.ijrcog20183807 · W2889264163
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This study evaluated hysterolaparoscopy in 50 infertile women, finding various pathologies and a 32% conception rate post-procedure.

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This prospective observational study evaluated the role of combined diagnostic hysterolaparoscopy in 50 women aged 20–40 years with primary or secondary infertility, using detailed history and clinical examination followed by laparoscopy and hysteroscopy with operative interventions when indicated. Laparoscopic findings included endometriosis (20%) among other factors (e.g., polycystic ovaries, tubal factors, adhesions, fibroids, and PID), and hysteroscopic findings included uterine septum (16%) and T-shaped cavity (14%), among others. During the study period, 32% of women conceived after the procedure. The authors conclude that combined simultaneous diagnostic laparoscopy and hysteroscopy with operative interventions should be performed in all infertile patients, but the study’s main limitation is the lack of a comparison group to determine causal contribution. This paper is centrally about endometriosis — it reports laparoscopic endometriosis findings (20%) within an infertility evaluation using hysterolaparoscopy.

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Abstract

Background: Infertility is one of the most important and underappreciated reproductive health problems in developing countries. The aim of the present study was to evaluate the role of hysterolaparoscopy in infertility.Methods: It was observational prospective study. In this study, 50 patients in the age group of 20-40 years who are anxious to conceive formed the study group. All women were subjected to a detailed history taking followed by clinical examination.Results: Out of 50 cases studied, 30 (60%) were of primary infertility while, 20 (40%) were of secondary infertility. Laparoscopic findings were as follows, 28% had polycystic ovaries, 20% had endometriosis, 18% had tubal factors, 18% had adhesions, and 8% had fibroids while 4% had PID. Hysteroscopic findings were uterine septum in 16%, T shaped cavity in 14%, shaggy-hyperplastic endometrium in 10% while adhesions and polyps in 8% and 4% respectively. 16 women (32%) conceived after the procedure during the study period.Conclusions: It is concluded that while investigating the causes of female infertility combined simultaneous diagnostic laparoscopy and hysteroscopy with operative interventions wherever indicated should be performed in all infertile patients before treatment, especially in women with age more than 30 years.
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Background

Infertility is one of the most important and underappreciated reproductive health problems in developing countries. The aim of the present study was to evaluate the role of hysterolaparoscopy in infertility.

Methods

It was observational prospective study. In this study, 50 patients in the age group of 20-40 years who are anxious to conceive formed the study group. All women were subjected to a detailed history taking followed by clinical examination.

Results

Out of 50 cases studied, 30 (60%) were of primary infertility while, 20 (40%) were of secondary infertility. Laparoscopic findings were as follows, 28% had polycystic ovaries, 20% had endometriosis, 18% had tubal factors, 18% had adhesions, and 8% had fibroids while 4% had PID. Hysteroscopic findings were uterine septum in 16%, T shaped cavity in 14%, shaggy-hyperplastic endometrium in 10% while adhesions and polyps in 8% and 4% respectively. 16 women (32%) conceived after the procedure during the study period.

Conclusions

It is concluded that while investigating the causes of female infertility combined simultaneous diagnostic laparoscopy and hysteroscopy with operative interventions wherever indicated should be performed in all infertile patients before treatment, especially in women with age more than 30 years. Metrics

References

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