Role of hystero-laparoscopy in evaluation of infertility: a retrospective observational study

In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2025 · vol. 14(9) , pp. 3004–3008 · doi:10.18203/2320-1770.ijrcog20252732 · W4413800685
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This retrospective observational study evaluated the diagnostic and therapeutic role of combined hysteroscopy and laparoscopy in 140 infertile women treated at AIIMS Raipur between June 2021 and June 2023. Records showed that most hysteroscopies were normal, while uterine septum was the most common intrauterine abnormality; laparoscopy identified adhesions in 30%, ovarian pathology in 28.57%, and endometriosis in 15.71%, with adhesiolysis, cystectomy, and myomectomy performed when indicated. Hystero-laparoscopy provided findings and opportunities for treatment beyond noninvasive imaging, although the paper reports no specific major limitation beyond its retrospective, single-center design. This paper is centrally about endometriosis — its laparoscopic detection as one of several pelvic pathologies identified during infertility evaluation.

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Abstract

Background: Infertility affects 8-10% of couples worldwide. Hystero-laparoscopy offers a dual diagnostic and therapeutic advantage in evaluating infertility, particularly where standard imaging falls short. Objective was to assess the diagnostic value of hystero-laparoscopy in female infertility and identify associated pelvic and intrauterine pathologies. Methods: A retrospective observational study was conducted at AIIMS, Raipur from June 2021 to June 2023, including 140 infertile women (83 with primary and 57 with secondary infertility). Patient records were reviewed for clinical, sonographic, hysteroscopic, and laparoscopic findings, including interventions. Data were analysed using SPSS v22. Results: Mean age was 28.6±4.3 years; mean infertility duration was 4.4±2.2 years. 73.57% of hysteroscopies were normal; uterine septum (15.71%) was the most frequent abnormality. Laparoscopy revealed adhesions (30%), ovarian pathologies (28.57%), and endometriosis (15.71%). Tubal block was noted in 57.85% by HSG. Interventions included adhesiolysis (28.57%), cystectomy (20.71%), and myomectomy (8.57%). Conclusions: Hystero-laparoscopy provides a comprehensive approach to evaluate and treat underlying causes of infertility, especially those undetected by non-invasive imaging.
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Background

Infertility affects 8-10% of couples worldwide. Hystero-laparoscopy offers a dual diagnostic and therapeutic advantage in evaluating infertility, particularly where standard imaging falls short. Objective was to assess the diagnostic value of hystero-laparoscopy in female infertility and identify associated pelvic and intrauterine pathologies.

Methods

A retrospective observational study was conducted at AIIMS, Raipur from June 2021 to June 2023, including 140 infertile women (83 with primary and 57 with secondary infertility). Patient records were reviewed for clinical, sonographic, hysteroscopic, and laparoscopic findings, including interventions. Data were analysed using SPSS v22.

Results

Mean age was 28.6±4.3 years; mean infertility duration was 4.4±2.2 years. 73.57% of hysteroscopies were normal; uterine septum (15.71%) was the most frequent abnormality. Laparoscopy revealed adhesions (30%), ovarian pathologies (28.57%), and endometriosis (15.71%). Tubal block was noted in 57.85% by HSG. Interventions included adhesiolysis (28.57%), cystectomy (20.71%), and myomectomy (8.57%).

Conclusions

Hystero-laparoscopy provides a comprehensive approach to evaluate and treat underlying causes of infertility, especially those undetected by non-invasive imaging. Metrics

References

Kumar A, Sharma S, Sethi R, Gupta S, Gupta V, Sharma R, et al. Diagnostic laparoscopy in evaluation of female infertility. Int J Reprod Contracept Obstet Gynecol. 2017;6(9):3925-9. Tsuji I, Ami K, Miyazaki A, Hoshiai H, Katayama H, Tamakoshi K, et al. Laparoscopic chromopertubation versus hysterosalpingography in assessment of tubal patency. Fertil Steril. 2009;92(5):1646-9. Kabadi YM, Reddy CM, Devi PK, Kumari PK, Bhasker V, Murthy AS, et al. Laparoscopic evaluation of female infertility. J Obstet Gynaecol India. 2013;63(5):336-9. Chanu SM, Singh NN, Sharma L, Singh NB, Singh WM, Singh CM, et al. Laparoscopic findings in infertility: Experience from a tertiary care hospital. J Med Soc. 2015;29(1):26-9. DOI: https://doi.org/10.4103/0972-4958.158918 Varlas VN, Vlachos A, Vavilis D, Nasioutziki M, Bontis J, Sotiriadis A, et al. Single-session hysteroscopy and laparoscopy in infertility investigation. Eur J Obstet Gynecol Reprod Biol. 2013;171(1):102-5. Sahu L, Tempe A, Gupta S, Mittal S, Mittal S, Suri V, et al. Laparoscopic evaluation of female infertility and pelvic pathology. Arch Gynecol Obstet. 2011;283(3):597-602. Kelekci S, Kaya E, Alan M, Erdemoglu M, Bilge U, Mollamahmutoglu L, et al. Comparison of hysterosalpingography and laparoscopy in diagnosis of tubal factor infertility. Arch Gynecol Obstet. 2005;272(3):245-8. Bosteels J, Kasius J, Weyers S, Broekmans FJ, Mol BW, D’Hooghe TM, et al. Hysteroscopy for treating subfertility associated with suspected major uterine cavity abnormalities. Cochrane Database Syst Rev. 2015;(2):CD009461. DOI: https://doi.org/10.1002/14651858.CD009461.pub3 Nayak PK, Mahapatra PC, Mallick J, Swain S, Mitra S, Sahoo J, et al. Role of diagnostic hysteroscopy in evaluation of infertility. J Hum Reprod Sci. 2013;6(4):213-8. DOI: https://doi.org/10.4103/0974-1208.112378 Swart P, Mol BW, van der Veen F, van Beurden M, Redekop WK, Bossuyt PM, et al. The accuracy of hysterosalpingography in the diagnosis of tubal pathology: a meta-analysis. Fertil Steril. 1995;64(3):486-91. DOI: https://doi.org/10.1016/S0015-0282(16)57781-4 Watrelot A, Dreyfus JM, Andine JP, Gervaise A, de Tayrac R, Descamps P, et al. Evaluation of the role of laparoscopy in infertility investigation: a multicentre prospective study. Hum Reprod. 1999;14(8):1921-6. Sharma R, Sharma A, Soni A, Sharma A, Singh V, Rathore SB, et al. Combined hysteroscopy and laparoscopy in female infertility: a single-session approach. Int J Reprod Contracept Obstet Gynecol. 2016;5(7):2145-9.

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