Evaluation of female factors in infertility by diagnostic laparohysteroscopy in a tertiary health care centre
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20203501Keywords:
Hysteroscopy, Infertility, LaparoscopyAbstract
Background: The inability to conceive is one of the most distressing conditions for a couple. It not only makes the female incomplete but also the social taboos attached are phenomenal. The problem of infertility as long as the recorded history of mankind. Fertility in our culture stands for reproductivity, growth and continuity. Reproduction is one of the basic essential for the survival of a species. Diagnostic laparoscopy & hysteroscopy have emerged as an accurate method of assessing, evaluating and treating infertility. Direct visualization of the abdominal and pelvic organs in laparohysteroscopy allows a definitive diagnosis to be made in many conditions where clinical examination and less invasive techniques such as ultrasound and hysterosalpingography fail to identify the problem.
Methods: A prospective study was conducted in Department of Obstetrics and Gynaecology, AGMC& GBP Hospital Agartala. 50 infertile women suspected with pelvic (tubal, peritoneal, adnexal) and intrauterine (uterine polyp, septa, submucous fibroid, intrauterine adhesions) pathologies were included in the study for further evaluation and correlation of clinical findings with Laparohysteroscopy observations.
Results: Out of 50 cases, 27 (54%) patients had primary infertility. While laparoscopy detected abnormalities in 60% of the cases, significant hysteroscopy findings were noted in 66% of cases. The most common laparoscopic abnormality was tubal (22%) ovarian and peritoneal (16%) in primary and secondary infertile patients respectively. On hysteroscopy, endometrial polyp (30%) was found as the commonest abnormality in both the groups.
Conclusions: Laparoscopy and hysteroscopy are both diagnostic and therapeutic procedures. If pathology is discovered, it can often be treated simultaneously. Laparoscopy combined with hysteroscopy is the sole technique to have a direct view of the female reproductive tract and to find out the various causes of infertility.
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References
Ombelet W, Cooke I, Dyer S, Serour G, Devroey P. Infertility and the provision of infertility medical services in developing countries. Human reproduction update. 2008;14(6):605-21.
Fathalla MF. Reproductive health: a global overview. Early Hum Dev. 1992;29:35-42.
Boivin J, Bunting L, Collins JA, Nygren KG. Reply: International estimates on infertility prevalence and treatment seeking: potential need and demand for medical care. Human reproduction. 2009;24(9):2380-3.
Chan 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.
Shamila S, Sasikala SL. Primary Report on the Risk Factors Affecting Female Infertility in South Indian Districts of Tamil Nadu and Kerala. Indian J Community Med. 2011;36(1):59-61.
Boivin J, Bunting L, Collins JA, Nygren KG. International estimates of infertility prevalence and treatment - seeking: potential need and demand for infertility medical care. Hum Reprod. 2007; 22:1506-12.
Aflatoonian A, Seyedhassani SM, Tabibnejad N. The epidemiological and etiological aspects of infertility in Yazd province of Iran. Iranian J Reprod Med. 2009;7:117-22.
International institute for population science. District level household & facility survey: TRIPURA fact sheet. 2007-08. Available at: http://rchiips.org/pdf/dlhs3/report/TR.pdf. Accessed on 23 September, 2019.
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 terminology, 2009. Fertil Steril. 2009;92(5):1520-4.
Aubuchon M, Burney RO, Schust DJ, Yao MW. Infertility and assisted Reproductive technology. Berek & Novak's Gynecology. Fifteenth ed: Lippincott Williams & Wilkins, a Wolters KLuwer business. 2012:1139.
Chaitra K, Prathima S, Chandraiah S, GS A. Laparoscopy as a diagnostic tool in evaluation of female factors in infertility. Int J Reprod Contracept Obstet Gynecol. 2017;6(3):864-7.
Rai A, Mishra MG. Diagnostic hystero-laparoscopy in work-up of female infertility. Inter J Reprod Contracep Obstet Gynecol. 2017;6(7):2853
Mehta AV, Modi AP, Raval BM, Munshi SP, Patel SB, Dedharotiya SM. Role of diagnostic hysterolaparoscopy in the evaluation of infertility. Int J Reprod Contracept Obstet Gynecol. 2016;5(2):437-0.
Practice Committee of the American Society for Reproductive Medicine. Diagnostic evaluation of the infertile female: a committee opinion. Fertility and sterility. 2015;103(6):e44-50.
Missmer SA, Hankinson SE, Spiegelman D, Barbieri RL, Marshall LM, Hunter DJ. Incidence of laparoscopically confirmed endometriosis by demographic, anthropometric, and lifestyle factors. American J Epidemiol. 2004;160(8):784-96.
Aziz N. Laparoscopic evaluation of female factors in infertility. J Coll Physicians Surg Pak. 2010;20(10):649-52.
Nayak P, Mahapatra P, Mallick J, 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):32-4.
Homer HA, Li TC, Cooke ID. The septate uterus: A review of management and reproductive outcome. Fertil Steril. 2000;73:1-14.
Donnez J, Jadoul P. What are the implications of myomas on fertility? A need for a debate? Hum Reprod. 2002;17:1424-30.
Pritts EA. Fibroids and infertility: A systematic review of the evidence. Obstet Gynecol Surv. 2001;56:483-91.
Hinckley MD, Milki AA. 1000 office-based hysteroscopies prior to in vitro fertilization: Feasibility and findings. JSLS. 2004;8:103-7.
Shalev J, Meizner I, Bar-Hava I, Dicker D, Mashiach R, Ben-Rafael Z. Predictive value of transvaginal sonography performed before routine diagnostic hysteroscopy for evaluation of infertility. Fertil Steril. 2000;73:412-7.
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