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

Tulika Chouhan; Vinita Singh

doi:10.18203/2320-1770.ijrcog20252732

Authors

Tulika Chouhan Department of Obstetrics and Gynecology, Norfolk and Norwich University Hospital, United Kingdom
Vinita Singh Department of Obstetrics and Gynecology, All India Institute of Medical Sciences Raipur, Chhattisgarh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20252732

Keywords:

Diagnostic laparoscopy, Hystero-laparoscopy, Infertility, Reproductive health, Tubal factor, Uterine anomalies

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.

Metrics

Metrics Loading ...

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.