Published: 2019-06-29

Role of hysterolaparoscopy in unexplained infertility

Shubha Choudhary, Meena Priyadharshini V., Ameya Sirsat, Sunita R. Tandulwadkar


Background: Infertility, as defined by World Health Organization (WHO), is failure to achieve pregnancy during 1 year of regular unprotected intercourse. The objective of this study was to determine the incidence of unsuspected pathology at hysterolaparoscopy in presumed unexplained infertility, the incidence of intervention done for correcting pathology and its outcome and the importance of hysterolaparoscopy in the evaluation and treatment of infertile couples.

Methods: This prospective observational study was carried out at IVF and Endoscopy centre, Department of obstetrics and gynecology at the Ruby Hall clinic, Pune from 1st November 2014 to 30th July 2016, after obtaining institutional ethical clearance and who met the inclusion and exclusion criteria. A detailed clinical history and physical examination and bimanual pelvic examination were done, following which all the patients were subjected to baseline blood investigation, 3D pelvis (TVS) and semen analysis. Day care hysterolaparoscopy was performed and systematic analysis were done.

Results: The mean duration of infertility was 2 to 4 years. In our study out of 75 women 62 (82.67%) showed normal hysteroscopic findings, remaining 13 women (17.67%) showed abnormal hysteroscopic findings like cornaul blockage, intrauterine adhesions and tuberculosis endometrium. Abnormal laparoscopic findings were reported in 29.33% of which the most common pathology was endomertiosis (21.33%).

Conclusions: Diagnostic Hysterolaproscopy is a safe, effective, minimally invasive, cost effective, daycare comprehensive procedure in evaluation of unexplained infertility. Apart from routine diagnostic protocol missed pathologies can be detected and this tool can be used for diagnostic as well as therapeutic intervention.


3D ultrasound pelvis, Cornual blockage, Endometriosis, Hysterolaproscopy, Intrauterine adhesions, Unexplained infertility

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Dyer SJ. International on infertility prevalence and treatment seeking: Potential need and demand for medical care. Hum Reprod. 2009;24:2379-80.

The Practice Committee of the American Society for Reproductive Medicine. Optimal evalution of the infertile female. Fertil Steril. 2006;86(5 suppl):S264-S267.

Esmaeilzadeh S, Delavar MA, Zeinalzadeh M, Mir MR. Epidemiology of infertility: a population-based study in Babol, Iran. Women Health. 2012;52:744.

Boivin J, Bunting L, Collins JA, Nygren KG. International estimates of infertility prevalence and treatment seeking. Potential need and demand for infertility and medical care. Humreprod. 2007;22:1506-12.

Rajan R. Postgraduate obstetrics, gynaecology, infertility and clinical endocrinology. 1st Ed. New Delhi: Jaypee Brothers; Chapter I, Practical management of infertility: An approach based on 1, pregnancies recorded over 12 years of experiences; 2005:3-17.

Gelbaya TA, Potdar N, Jeve YB, Nardo LG. Definition and Epidemiology of Unexplained Infertility. Obstet Gynecol Surv. 2014;69(2):109-15.

Begum J, Samal S, Ghose S, Palai P, Samal R. Combined hysterolaparoscopy as an early option for initial evaluation of female infertility: A retrospective study of 135 patients. Int J Reprod Contracept Obstet Gynecol. 2015;4:584-8.

Ashraf M Kansoth AM, Elbalshy AE. Laparoscopic presentation in unexplained infertility; a retrospective study. J Med Sci Res. 2018;1:312-6.

Jaykrishnan, Koshy AK, Raju R. Role of laparohysteroscopy in women with normal pelvic imaging and failed ovulation stimulation with intrauterine insemination. J Hum Reprod Sci. 2010;3:20-4.

Chanu SM, Rudra Pal GS, Panda S, Santa Singh AS. Diagnostic hysterolaparoscopy for evaluation of infertility: Our experience in a tertiary Care Hospital. J Hum Reprod Sci. 2018;11:19-23.

Parveen S, Khanna M. Role of combined diagnostic laproscopy and simultaneous diagnostic hysteroscopy for evaluation of female subfertility factors. J SurgPak (Int). 2010;15(1):44-7.

Boudhraa K, Jellouli MA, Kassasoui O, Ben Aissia N, Ouerhani R, Triki A, et al. Role of the hysteroscopy and laproscopy in management of the female infertility: about 200 cases. Tunis Med. 2009;87(1):55-60.

Malhotra N, Sood M. Role of hysteroscopy in infertile women. Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi.J India Med Assoc. 2001;95(9):499-525.

Bhandhari S, Singh A, Agarwal P, Ganguli I. Findings in diagnostic laparoscopy in patients with unexplained infertility. Fertil Sci Res. 2015;2:29-33.

Tsuji I, Ami K, Miyazakai A, Hujinami N, Hoshiai H, Benefit of diagnostic laparoscopy for patients with unexplained infertility and normalhysterosalpingography findings. Tohoku J Exp Med. 2009;219:39-42.

Bonneau C, Chanelles O, Sifer C, Poncelet C. Use of laparoscopy in unexplained infertility. Eur J Obstet Gynecol Reprod Biol. 2012;163:57-61.