Role of diagnostic hysterolaparoscopy in evaluation of primary infertility

SUMMARY AND CONCLUSION : This prospective study evaluated 200 patients of primary infertility by diagnostic hysterolaparoscopy, following the inclusion & exclusion criteria at Government Kilpauk Medical College Hospital, Chennai. Complete information on the status of patients’ reproductive tract is obtained. Both intrauterine and pelvic pathology could be detected at the same sitting. It minimises hospital stay and decreases cost and also the surgical and anasthetic risks to the patients. In this prospective study of 200 patients of primary infertility diagnostic Hysterolaparoscopy was found to be extremely useful. 1. Presence of peritoneal factors, tubal factors and endometrial factors were diagnosed in the same sitting thereby improving the efficacy of infertility evaluation. 2. It avoids unnecessary radiological evaluation in a majority of cases. 3. It decreases hospital stay and decreases cost and inconveniences to the patients. 4. Patient is not exposed to anasthesia too often, as Hysteroscopy and Laparoscopy were combined in a single sitting. 5. It also decreases the time required to complete the initial infertility work up. 6. Among the infertile females attending KMCH, about 37.5% were found to have abnormalities in Diagnostic Hysterolaparoscopy. 7. The major abnormality was found to be in the ovaries.(58%) 8. The next major pathology was in the fallopian tubes as bilateral tubal block (16%) 9. The other fractions of pathology (26%) were variably dispersed among the uterine fibroids, peritoneal adhesions, intrauterine adhesions and endometriosis. 10. Majority of the patients diagnosed to have abnormalities were treated accordingly by medical (or) surgical management Hence Diagnostic Hysterolaparoscopy is a safe, time- saving and effective tool in the panoramic evaluation of the infertile female.