Publication:

Laparoscopy and hysteroscopy in patients of infertility in a rural set up

Background Infertility is a life crisis. The number of couples seeking medical help for infertility is increasing dramatically. The incidence of infertility in any community varies between 5-15%.  This problem is compounded by the trend towards delayed child bearing to achieve socio-economic, educational and professional goals and the rapidly diminishing availability of adoptable infants. These couples are relatively well informed. Diagnostic laparoscopy & hysteroscopy have emerged as an accurate method of assessing, evaluating and treating infertility. Direct visualization of the abdominal and pelvic organs in laparoscopy allows a definitive diagnosis to be made in many conditions where clinical examination and less invasive techniques such as ultrasound and HSG fail to identify the problem.

Methods A prospective study conducted in Department of Obstetrics and Gynaecology, JNMC, AVBRH, and DMIMS. 60 women with H/O infertility for ≥ 1 year were enrolled and subjected to diagnostic tests. Cases with diagnosed tubal blockage, active lower genital tract infection, suspected pregnancy, tuberculosis and high risk medical disorders were excluded.

Results Endometriosis 32%, ovarian disorder (22%), Intra uterine synechiae and cervical stenosis together 14%, tubal block (6%) tubal pathology (delayed spill) (18%).

Conclusions Laparoscopy and hysteroscopy detects pelvic pathology which can appear to be normal on other imaging modalities and provides direct visualization as well as treatment of the diseased condition. Laparoscopy and hysteroscopy combined together are valuable technique for complete assessment of female factors of infertility patient and should be used early in the diagnostic work up in cases of infertility.