Role of hysterolaparoscopy in the diagnosis and management of infertility
Keywords:Diagnosis, Hysterolaparoscopy, Infertility, Operative procedure
Background: Infertility is defined by WHO and ICMART as a disease of the reproductive system by the failure to achieve a clinical pregnancy after 12 months or more regular unprotected sexual intercourse. Objective of this study were to assess the role of hysteroscopy and laparoscopy in the evaluation of female infertility. To assess the therapeutic role of these endoscopic modalities in cases of infertility.
Methods: A prospective study of 112 women coming with the complain of infertility to a tertiary care centre hospital in Ahmedabad over a period of 30 months from January 2017 to June 2019.
Results: Of the 112 cases, 69.7% had primary infertility and 30.3% had secondary infertility. Septum was the most common hysteroscopic finding (7.1%) followed by polyps (5.4%) and synechiae (3.6%). Adhesions was the most common laparoscopic finding (23.2%) followed by tubal blocks (19.7%) and fibroid (17.9%). Polycystic ovaries were seen in 12.5% patients followed by endometriosis in 10.7% women. Myomectomy was most common therapeutic procedure (17.9%) followed by adhesiolysis in 14.3% women and PCO drilling in 8.9% women.
Conclusions: Hysterolaparoscopy is useful as a diagnostic and therapeutic measure for women having infertility.
Zegers-Hochschild F, Adamson GD, De Mouzon J, Ishihara O, Mansour R, Nygren K, et al. The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) Revised Glossary on ART Terminol. 2009;92(5).
Resolve, The National Infertility Association, “National Survey of Family Growth, CDC, 2006-2010”. Available at: https://resolve.org/infertility-101/what-is-infertility/fast-facts/. Accessed on 3rd June 2019.
Fertility within reach: Advocating for fertility health benefits, 2019. Available at: http://www.fertilitywithinreach.org/about. Accessed on 2nd June 2019.
Health Information from the National Library of Medicine, 2018. Available at: Retrieved from https://medlineplus.gov. Accessed on 2nd June 2019.
The Practice Committee of the American Society for Reproductive Medicine. Fertil Steril. 2015:0015-0282. Available at: http://dx.doi.org/10.1016/j.fertnstert.2014.12.103. Accessed on 2nd June 2019.
Gianaroli L, Racowsky C, Geraedts J, Cedars M, Makrigiannakis A, Lobo LA. Best practices of ASRM and ESHRE: a journey through reproductive medicine. Fertil Steril. 2012;98(6):0015-0282.
Mohr J, Lindemann HS. Hysteroscopy in the infertile patients. J Reprod Med. 1977;19(3):161-2.
Ahmed MS, Bhalerao AN. Role of diagnostic hysterolaparoscopy in evaluation of female infertility. Int J Reprod Contracept Obstet Gynecol. 2017;6(9):4048-51.
Sachdeva PK, Kaur N. Role of hysterosalpingography and diagnostic laparoscopy in infertility. Int J Reprod Contracept Obstet Gynecol. 2016;5(11):3743-9.
Samal S, Agrawal S, Agrawal M. Role of laparoscopy in infertility in a rural setup hospital. Int J Reprod Contracept Obstet Gynecol. 2014;3(1):185-8.
Nayak PK, Mahapatra PC, Mallick JJ, Swain S, Mitra S, Sahoo J. Role of diagnostic hystero-laparoscopy in the evaluation of infertility: a retrospective study of 300 patients. J Hum Reprod Sci. 2013;6(1):32-34.
Female infertility: an approach to the problem of infertility. The proper diagnostic tests and their correct interpretations, Chapter 17. In: Marc A. Fritz and Leon Speroff. Clinical Gynecologic Endocrinology and Infertility. 8th ed. South Asian edition: Wolters Kluwer; 2016:1173-1175.
Antaratani RC, Harsha B. Hysterolaparoscopy in the evaluation and management of female infertility. Int J Reprod Contracept Obstet Gynecol. 2017;6(10):4454-7.
Vaid K, Mehra S, Verma M, Jain S, Sharma A, Bhaskaran S. Pan endoscopic approach “hysterolaparoscopy” as an initial procedure in selected infertile women. J Clin Diagn Res. 2014;8(2):95-8.
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. Mater Sociomed. 2014;26(3):156-7.