Abstract
Objective: This is a Prospective analytical study carried out in department of Obstetrics and Gynecology, Hi-Tech Medical College & Hospital, Bhubaneswar, a tertiary care centre, to find out the role of combined laparoscopy and simultaneous hysteroscopy in the management of infertility.
Materials and Method: A total of 70 women who reported with complaint of infertility were chosen for study. The women were evaluated for female factor by laparoscopy and simultaneous hysteroscopy. Tubal patency study was also done. The study was conducted over a two year period i.e .from November 2018 to October 2020 at Hi-Tech Medical College & Hospital, Bhubaneswar.
Results: Age of the women ranged from 21 to 40 years and the mean age was 27.97 years. In hysteroscopy, endometrial polyp, cervical stenosis, submucous fibroid, ostial block and septate uterus was identified. In laparoscopy, various pathologies like polycystic ovarian disease, endometriosis, bilateral and unilateral tubal block, pelvic adhesions, myomas and uterine anomalies were detected.
Conclusion: In investigating the causes of female infertility, a combined laparoscopy with simultaneous hysteroscopy provides the best approach to diagnose the pathologies.
Keywords: Laparoscopy, Hysteroscopy, Infertility.
References
- Puri S, Jain D, Kaushal S, Deol SK. Laparohysteroscopy in female infertility : a diagnostic cum therapeutic tool in Indian setting. Int J Applied Basic Med Res. 2015; 5(1): 46-48.
- Jansen FW, Vredevoogd CB, van Ulzen K, Hermans J, Trimbos JB, Trimbos-Kemper TC. Complications of hysteroscopy : a prospective , multicenter study. Obstet Gynecol. Aug 2000; 96(2): 266-70.
- Zhang E, Zhang Y, Fang L, Li Q, Gu J. Combined hysterolaparoscopy for the diagnosis of female infertility : A retrospective study of 132 patients in China. Materia Socio Medica. 2014; 26(3): 156-7.
- Nayak PK, Mohapatra PC, Mallik JJ, Swain S, Mitra S, Sahoo J. Role of diagnostic hysterolaparoscopy in the evaluation of infertility : A retrospective study of 300 patients. J Human Repod Sci. 2009; 6(1): 32-4.
- Vaid K, Mehra S, Varma M, Jain S, Sharma A, Bhaskaran S. Pan-endoscopic approach “ Hysterolaparoscopy as an initial procedure in selected infertile women.” JCDR. 2014; 8(2): 95-8.
- Piewankieyicz B, Stelmachow J, Sawicki W, Cendrowski K, Wypych P, Swiderska K. The effectiveness of hysteroscopic polypectomy in cases of female infertility. Clin Exp Obstet Gynecol. 2003; 30(1): 23-5.
- Shokeir TA, Shalan HN, El-Shafei MM. Significance of endometrial polyps detected hysteroscopically in eumenorrhic infertile women. J Obstet Gynecol Res. 2004; 30(2): 84-9.
- Bosteels J, Kasius JC, Weyers S, Broekmans FJ, Mol BW, D’Hooghe T. Hysteroscopy for treating subfertility associated with suspected major uterine cavity abnormalities. Cochrane Database of Systemic Reviews. 2013; 1(1).
- Mollo A, De Franciscis P, Colacurci N, Cobellis L, Perino A, Venezia R et al. Hysteroscopic resection of the septum improves the pregnancy rate of women with unexplained infertility : A prospective controlled trial. Fertil Steril 2009 Jun 1; 91(6): 2628-31.
- Hou HY, Chen YQ, Li TC, Hu CX, Chen X, Yang ZH. Outcome of laparoscopy-guided hysteroscopic tubal catheterization for infertility due to proximal tubal obstruction. J Minim Invasive Gynecol. 2014; 21(2): 272-8.
- Pansky M, Feingold M, Sagi R, Herman A, Schneider D, Halperin R. Diagnostic hysteroscopy as a primary tool in a basic infertility work-up. JSLS 2006; 10(2): 231-235.
- Brown SE, Coddington CC, Schnorr J, Toner JP, Gibbons W, Oehninger S. Evaluation of outpatient hysteroscopy, saline infusion hysterosonography and hysterosalpingography in infertile women : a prospective, randomized study. Fertil Steril 2000; 74: 1029-1034.
- Naworth F, Foth D, Schmidt T. Minihysteroscopy as routine diagnostic procedure in women with primary infertility. J Am Assoc Gynecol Laparosc. 2003; 10(3): 396-398.
- Brusco GF, Arena S, Angelini A. The role of diagnostic hysteroscopy in infertile women. Minerva Gynecol. 2001; 53(5): 313-319.
- Grimbizis GF, Camus M, Tarlatzis BS, Bontis JN, Devroey P. Clinical implications of uterine malformations and hysteroscopic treatment results. Hum Reprod Update. 2007; 7(1): 161-174.
- Perez-Medina T, Bajo-Arenas J, Salazar F, Redondo T, Sanfrutos L, Alvarez P. Endometrial polyps and their implication in the pregnancy rates of patients undergoing intrauterine insemination: a prospective randomized study. Hum Reprod . Jun 2005; 20(6):1632-5.
- Donnez J, Jadoul P. What are the implications of myomas on fertility ? A need for a debate ? Hum Reprod. Jun 2002; 17(6):1424-30.
- Practice Committee of American Society for Reproductive Medicine in collaboration with Society of Reproductive Surgeons. Myomas and reproductive function. Fertil Steril. Nov 2008; 90(5 Suppl): S125-30.
- Di SpiezioSardo A, Mazzon L, Bramante S, Bettochi S, Bifulco G, Guida M. Hysteroscopic myomectomy: a comprehensive review of surgical techniques. Hum Reprod Update. Mar-Apr 2008; 14(2): 101-19.
- Somigliana E, Vercellini P, Benaglia L, Abbiati A, Barbara G, Fedele L. The role of myomectomy in fertility enhancement .Curr Opin Obstet Gynecol. Aug 2008; 20(4): 379-85.
- Benecke C, Kruger TF, Siebert TI, Van der Merwe JP, Steyn DW. Effect of fibroids on fertility in patients undergoing assisted reproduction. A structured literature review. Gynecol Obstet Invest. 2005; 59(4): 225-30.
- Pritts EA. Fibroids and infertility : a systematic Review of the evidence . Obstet Gynecol Surv. Aug 2001; 56(8): 483-91.
- Broome JD, Vancaillie TG. Flouroscopically guided hysteroscopic division of adhesions in severe Asherman syndrome .Obstet Gynecol. Jun 1999; 93(6): 1041-3.
- Homer HA, Li TC, Cooke ID. The septate uterus : a review of management and reproductive outcome. Fertil Steril . Jan 2000; 73(1): 1-14.
- Pabuccu R, Onalan G, Kaya C, Selam B, Ceyhan T, Ornek T. Efficiency and pregnancy outcome of serial intrauterine device guided hysteroscopic adhesiolysis of intrauterine synechiae. Fertil Steril. Nov 2008; 90(5) : 1973-7.
- Ozgur K, Isikoglu M, Donmez L, Oehninger S. Is hysteroscopic correction of an incomplete uterine septum justified prior to IVF ? Reprod Biomed Online. Mar 2007; 14(3): 335-40.
- Shokeir TA. Hysteroscopic management in submucous fibroids to improve fertility. Arch Gynecol Obstet. Nov 2005; 273(1):50-4.
- Surrey ES, Minjarez DA, Stevens JM, Schoolcraft WB. Effect of myomectomy on the outcome of assisted reproductive technologies. Fertil Steril. May 2005; 83(5): 1473-9.
- Thomson AJ, Abbott JA, Kingston A, Lenart M, VancaillieTG. Flouroscopically guided synechiolysis for patients with Asherman Syndrome : menstrual and fertility outcomes. Fertil Steril, Feb 2007; 87(2): 405-10.
- Parsanezhad ME, Alborzi S, Zarei A, Dehbashi S, Shirazi LG, Rajaeefard A. Hysteroscopic metroplasty of the complete uterine septum, duplicate cervix, and vaginal septum. Fertil Steril. May 2006; 85(5): 1473-7.
- Hucke J, De Bruyme T, Balan P. Hysteroscopy in infertility – diagnosis and treatment including falloposcopy. Gynecol Obstet 2000; 20: 13-20.
- Hourvitz A, Ledee H, Gervaize A, Fernandez H, Frydman R, Olivennes Should diagnostic hysteroscopy be a routine procedure during diagnostic laparoscopy in women with normal hysterosalpingography ? Reprod Biomed 2002; (4): 256-60.13.
- Boricha YG, Sharma RK, Boricha BG, Sabrina Mhapankar, Archana Chaterjee, Narsthetty J. Laparoscopy in 50 infertile couples : prospective study. IJMCR 2011; 2(2): 66-69.
- Godinjak Z, Idrizbegovic E. Should diagnostic hysteroscopy be a routine procedure during diagnostic laparoscopy in infertile women ? JBMS 2008; 8: 44-47.
- Marsha E Wolf, Janet R, Daling and Lynda F, Voigt. Prior Cesarean deliveryin women with secondary tubal infertility. AJPH November 1990; 80(11): 1382-1383.
- Sajida Parveen, Majidah Khanam. Role of combined laparoscopy and simultaneous diagnostic hysteroscopy for evaluation of female subfertility factors . Journal of surgery Pakistan (International) 2010; 15(1): 44-47.
Corresponding Author
Dr Sini Venugopal
Assistant Professor, Department of Obstetrics and Gynecology, Hi-Tech Medical College & Hospital, Bhubaneswar, Odisha, India
DOI: https://dx.doi.org/10.18535/jmscr/v9i7.13
