A prospective study on the role of Hysterolaparoscopy in the evaluation of infertility

Infertility affects about 10-15% of couples of reproductive age groups. The current evidence indicates a 9% prevalence of infertility with 56% of couples seeking medical care. Hysterolaparoscopy provides a comprehensive investigative procedure in which various factors causing female infertility can be assessed at one sitting.

A total 100 infertile women between 20-40 years of age including primary and secondary infertility were evaluated. Patients would be investigated thoroughly for infertility and in preparation for anaesthesia. Tests include follicular study, Ultrasound pelvis. Hysterolaparoscopy was performed in the pre ovulatory period between days 6-10 of the cycle for infertility evaluation.

In the present study out of 100 cases for infertility evaluated, primary infertility were 57(57%) and secondary infertility were 43(43%). In our study out of 100 patients, Hysterolaparoscopy showed tuberculosis in 24 (24%) patients, remaining were endometriosis, polycystic ovarian syndrome, congestion, intra-pelvic adhesions, hydro-salpinx.

It is concluded that while treating the causes of female infertility combined simultaneous diagnostic laparoscopy and hysteroscopy should be performed in all infertile patients as” seeing is believing” and if any pathologies found to be operable the gynaecologist can perform operative hystero-laparoscopy at that time, hence anticipating the pathologies after pre-operative work up is very important. Metrics

Begum J, Samal S, Ghose S, Pallavee P, Samal R. Combined hysterolaparoscopy as an early option for initial evaluation of female infertility: a retrospective study of 135 patients. Int J Reprod Contracept Obstet Gynecol. 2015;4:584-8. Raksha S, Gupta BD, Shah K. Role of diagnostic hysterolaparoscopy in evaluation of primary and secondary infertility. Int J Conte Med Res. 2016;3(3):768-72. Shobha D, Madhu KN, Agrawal A. Role of diagnostic hysterolaparoscopy in evaluation of primary and secondary infertility. J Evolut Med Dent Sci. 2014;3(9):2194-207. Mascarenhas MN, Flaxman SR, Boerma T, Vanderpoel S, Stevens GA. National, regional, and global trends in infertility prevalence since, 1990: a systematic analysis of 277 health surveys. PLoS Med. 2012;9(12):e1001356. Mali K, Mohanty S. To study the role of hysteroscopy and laparoscopy in the evaluation of infertility. Int J Reprod Contracept Obstet Gynecol. 2016;5:3027-31. Borchia YG, Sharma RK, Borchia BG, Mhapankar S, Chaterjee A. Laparoscopy in 50 infertile couples prospective study. IJMCR. 2011:2(2):66. Nayak PK, Mahapatra PC, Mallick JJ, Swain S, Mitra S, Sahoo J. Role of diagnostic hystero-laparoscopy in the evaluation of infertility: A retrospective study of 300 patients. J Hum Reprod Sci. 2013;6:32. Godinjak Z, Idrizbegovic E. Should diagnostic hysteroscopy be a routine procedure during diagnostic laparoscopy in infertile women? JBMS. 2008;8:44-7. Isikoglu M, Berkkanoglu M, Senturk Z, Coetzee K, Ozgur K. Endometrial polyps smaller than 1.5 cm do not affect ICSI outcome. Reprod Biomed Online. 2006;12(2):199-204. Jayakrishnan K, Koshy AK, Raju R. Role of laparohysteroscopy in women with normal pelvic imaging and failed ovulation stimulation with intrauterine insemination. Hum Reprod Sc. 2010;3:20-4. Rai A, Mishra MG. Diagnostic hystero-laparoscopy in work-up of female infertility. Int J Reprod Contracept Obstet Gynecol. 2017;6:2852-7. Donnez J, Jadoul P. What are the implications of myomas on fertility? A need for a debate?. Hum Reprod. 2002;17(6):1424-30. Parveen S, Khanam M. Role of combined diagnostic laparoscopy and simultaneous diagnostic hysteroscopy for evaluation of female subfertility actors. J Surg Pak. 2010;15(1):44-7.