Online ISSN: 2515-8260

Role of hysterolaparoscopy in evaluation of female infertility in a tertiary care centre of Tamil Nadu

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1Dr. SV Hemalatha, 2Dr. G Thenmozhi, 3Dr. MS Manickadevi, 4Dr. V Sughanya Krishnaveni

Abstract

Introduction: Diagnostic laparoscopy is a minimally invasive technique that provides information on the state of the uterus, ovaries, Fallopian tubes. It is considered as gold standard for diagnosing tubal and peritoneal diseases. Hysteroscopy helps in visualizing the uterine cavity and identifying the possible pathology in infertility. In combined hysterolaparoscopy complete evaluation and treatment is possible in the same sitting. Objective: To study the role of combined diagnostic hystero-laparoscopy in evaluation of female infertility. Materials and Methods: This retrospective study was conducted in the Department of Obstetrics and gynaecology in a tertiary care centre in Chennai, Tamil Nadu from January 2017 to December 2017. Women aged 20-40 years with primary or secondary infertility with normal hormonal profile and without male factor infertility were included. Results: In our study primary infertility was found in 75% of the 100 patients and secondary infertility in 25% of cases. Majority of patients of primary infertility (46%) and secondary infertility (44%) belonged to the age group of 25-30 years. The analysis of the duration of infertility showed that 66% of primary infertility cases had history of infertility between 1-5 years, 28% had infertility of 6-10 years. Among secondary infertility cases 64% had infertility between 1-5 years, 32% between 6-10 years. Abnormal laparoscopic findings were noted in 55% of cases of primary infertility and 52% in secondary infertility. Abnormal hysteroscopic findings were noted in 18% of primary infertility cases and 16% of secondary infertility. The most common laparoscopic findings in secondary infertility cases were adnexal adhesions (20%) and myoma (12%) and polycystic ovaries in primary infertility. In our study on chromopertubation 12% of primary infertility and 20% of secondary infertility patients had unilateral tubal block and 16% of primary infertility and 12% of secondary infertility patients had bilateral tubal block. Conclusion: Hysterolaparoscopy is a minimally invasive, safe and effective procedure in comprehensive evaluation of female infertility as it helps in detecting tubal, peritoneal factors, endometriosis, adnexal adhesions and septate uterus. The above correctable abnormalities are missed by imaging procedures. Hysterolaparoscopy helps in formulating specific planning of management. While investigating the causes of female infertility combined simultaneous diagnostic laparoscopy & hysteroscopy should be performed in all infertile patients.

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