[Role of the hysteroscopy and laparoscopy in management of the female infertility: about 200 cases].

AIM: Infertility is a common disease which affects nearly 10% of women at reproductive age. The hysteroscopy and laparoscopy are becoming very important in the management of this pathology. We tried to assess the current results of both hysteroscopy and laparoscopy, to study the prognosis factors as well as operating techniques and to clarify their contribution in comparison with other therapeutic techniques. METHODS: This is a retrospective study about 200 cases of hysterolaparoscopy performed for female infertility in women admitted at the department of Gynaecology and Obstetrics in Mongi Slim's Hospital La Marsa. RESULTS: The hysteroscopy was abnormal in 75% of cases: the uterine synechias (23%), endometria hypertrophy (19%), endometrial polyps (10%), uterine fibroids (9%), atrophy (7.5%) and malformations (3.5%). The operating hysteroscopy procedure was performed in 27.3% of cases with a rate of subsequent pregnancy in 34.9%. There is different data between the hysterosalpingography and hysteroscopy in 34.8%. The operating laparoscopy was performed in 70% of cases divided between adhesiolysis (27.2%), tubal surgery (37.8%), electrocoagulation or excision of endometriosis nodule (17.2%) and ovarian drilling for PCOS (17.8%). The rate of pregnancy is 39.9% after laproscopic surgery (divided between intrauterine pregnancy 37.1% and ectopic pregnancy 2.8%). The data of the hysterosalpingography and laparoscopy are different in 21.1%. CONCLUSION: Hysteroscopy and laparoscopy are diagnosing and treating both uterine and tubal infertility as well as some ovarian abnormalities. They have, thus, the main role in diagnosis and treatment of female infertility. They permit to correct data from the HSG in more than a quarter of cases and to improve the rate of pregnancy in more than one third of cases.