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Category: Volume 07 Issue 01 January 2019
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Title: Role of Diagnostic Hysterolaparoscopy in Female Infertility: A Retrospective Study

Authors: Dr Devarasetti Anurupa, Dr Ravikanth G O, Dr Geeta J Doppa, Dr Purushotham M.K

 DOI: https://dx.doi.org/10.18535/jmscr/v7i1.164

Abstract

Introduction: Diagnostic Laparoscopy is a minimally invasive technique that gives pelvic organs and provides information on the status of the fallopian tubes, ovaries and uterus. It is considered as gold standard for the diagnosis of various diseases e.g; pelvic inflammatory disease, endometriosis, cysts, pelvic congestion, fibroids and tuberculosis. Similarly, visualizing the uterine cavity and identifying the possible pathology has made hysteroscopy an essential part of infertility evaluation. Infertility accounts for 10-15 % of reproductive age couples. This study was undertaken with an aim to understand the role of diagnostic hysterolaparoscopy in cases of unexplained infertility.

Materials and Methods: This was a retrospective study of women with primary or secondary infertility presenting to our department. Patients between 20 and 45 years of age with infertility were included in this study on the basis of a predefined inclusion and exclusion criteria. Hormonal analysis (FSH, LH, Prolactin, and TSH) was done in indicated patients. Hysterolaparoscopy was done and corrective surgery was done if needed. Data was analyzed using SSPE 21.0 software. P value less than 0.05 was taken as statistically significant.

Results: A total of 24 infertile women were included in this study. 21 (87.5%) women had primary infertility and 3 (12.5%) had secondary infertility. The most common age group was found to be between 20-30 years (58.3%). 12 (50%) patients were married since more than 5 years. Most of the patients with infertility were asymptomatic (58.3%). 41.6% women were having some type of abnormal menstrual disorder. Abnormalities detected through laparoscopy were more in number than the abnormalities detected through hysteroscopy. In majority of the patients (79.1%) hysteroscopy was found to be normal. The most common pathology seen on hysteroscopy was uterine synechia (16.6%). On laparoscopy all patients were found to have some or the other pathology. The most common pathology found to be seen on laparoscopy was pelvic adhesion (33.33%) followed by endometriosis (29.16%) and polycystic ovaries (20.8%).

Conclusion: Hysterolaparoscopy is an effective, safe and minimally invasive procedure in the comprehensive evaluation of female infertility, as it could diagnose the pathologies such as endometriosis and periadnexal adhesions which otherwise could have been missed by other diagnostic modalities.

Keywords: Infertility, hysterolaparoscopy, Pelvic adhesions, endometriosis.

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Corresponding Author

Dr Ravikanth G O

Associate Professor, Department of Obstetrics and Gynaecology, KVG Medical College and Hospital, Sullia, D.K