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An Analytical Study of Combined Diagnostic Hysteroscopy and Laparoscopy in Evaluating Factors for Infertility

Nadkarni Vaibhav, Residen, Department of Obstetrics and Gynaecology, Geetanjali Medical College and Hospital (GMCH) Udaipur, Rajasthan 313001, India. , Nadkarni Vaibhav1 , Gupta Arun2 , Singh Sakshi3

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Indian Journal of Obstetrics and Gynecology 6(2):p 177-184, Mar-Apr 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijog.2321.1636.6218.17

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Abstract

Background: Almost 1015% of marriages prove to be childless. Infertility is inability of a couple to achieve conception after one year of unprotected coitus. Aims & Objectives: To evaluate the role of diagnostic hysteroscopy and laparoscopy in the assessment of primary and secondary infertility and to help in planning appropriate treatment and to study the frequency of various pathological conditions in female reproductive tract leading to infertility. Materials & Methods: A prospective study on 205 infertile women of age group 18 to 44 years visiting GMCH, Udaipur from October 2015 to October 2017. Hysterolaparoscopy was performed under general anesthesia in the preovulatory period between days 610 of the cycle for infertility evaluation. Routine investigations were performed. Results were tabulated in Microsoft Excel 2013 software and analyzed using SPSS16. Results: More primary (61.95%) than secondary infertility (38.05%). Maximum patients in 2630 years of age in primary and 3135 years of age in secondary infertility. Uterine septum and fibrosedostea (6.29% each) were main findings in primary whereas uterine polyp/fibroid was the main hysteroscopic finding in the secondary infertility. Endometrium was polypoidal in 4.72%, hyperplastic in 3.93% in the primary, 8.97% and 21.79% in secondary infertility respectively. Uterine perforation (1.57%) was the complication in the primary and gaseous distension of abdomen (3.84%) in the secondary infertility. Most common pathology was PID (16.08%) followed by fibroid 8.29%, endometriosis 7.8%, PCOD 7.31%, uterine septum, polyp/myoma and hydrosalphinx 6.34%, fibrosed ostea and TO mass 5.36%. Conclusion: Female infertility cases especially in whom all tests are normal, endometrial study helps to reduce the unexplained etiological factors in infertility and to know the ovulatory factor. Both laparoscopy and hysteroscopy combined together is a valuable technique for complete assessment of female factors of infertility especially in a symptomatic patient and should be used early in the diagnostic workup.

Keywords: Hysteroscopy; Laparoscopy; Infertility; Hysterolaparoscopy. 

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DOI: DOI: http://dx.doi.org/10.21088/ijog.2321.1636.6218.17

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