Comparitive Status Of Hysterosalpingography & Laparoscopy In Evaluation Of Infertile Women -

The present study aims to compare between the role of Hysterosalpingography and laparoscopy in the evaluation of infertile women & to analyse the advantage and disadvantage of laparoscopy over the conventional evaluation of tubal pathology by hysterosalpingography. This is a retrospective study of 200 cases of infertility which were first investigated by conventional methods and later laparoscopy was performed. It comprised 125 cases of primary infertility in whom no cause was detected on routine investigations and did not conceive within 6 cycles of ovulation induction and 75 cases of secondary infertility with abnormal tubal factor on HSG, attending the department of Obst. & Gynae. in M.M.C. and in a private hospital from 2006-2010. Hysterosalpingography was abnormal in 98 (49%) and normal in 102 (51%) cases while out of 200 cases of diagnostic laparoscopy, 140 (70%) of cases showed abnormalities in form of tubal block, fimbrial & peri-tubal adhesions, endometriosis, polycystic ovaries and required operative laparoscopic procedures in form of adhesiolysis for adhesions in 38(27.14%), fimbrioplasty & salpingostomy for agglutinated fimbria in 53 (37.85%), electrocoagulation or excision of endometriotic nodule in 25 (17.85%) and ovarian drilling for PCOD in 24 (17.85%). The HSG missed 56(28%) abnormal tubal and peri-tubal findings which were diagnosed with laparoscopy. Laparoscopy is diagnostic and therapeutic both for tubal and peri-tubal infertility as well as some ovarian abnormalities. It gives an advantage in diagnosis and treatment of female infertility at the same sitting. As compared to HSG, it is more accurate in 28% cases.