Publication:

Clinico-demographic profile, endoscopic findings and pregnancy outcomes in women with primary infertility: a decade of experience

Background Infertility affects a significant proportion of reproductive-age couples worldwide. Conventional investigations may fail to identify subtle pelvic and intrauterine pathologies that contribute to infertility in all cases. Combined hystero-laparoscopy offers the advantage of simultaneous diagnosis and treatment of such abnormalities. Objective was to analyse the clinico-demographic characteristics, endoscopic findings, management strategies, and pregnancy outcomes of women with primary infertility over a 10 year period at a tertiary care center.

Methods This retrospective observational study included 304 women who underwent combined hystero-laparoscopy for infertility evaluation at a tertiary care center. Demographic characteristics, hysteroscopic findings, laparoscopic findings, therapeutic interventions, and subsequent pregnancy outcomes were analysed. Continuous variables were expressed as mean±SD, while categorical variables were presented as frequencies and percentages.

Results The mean age of the study population was 29.1±4.1 years, and the mean duration of infertility was 7.6±3.0 years. Primary infertility was observed in 84.2% of women. Combined hystero-laparoscopy detected pelvic or intrauterine abnormalities in 72.4% of patients. Hysteroscopic abnormalities were identified in 11.8%, whereas laparoscopic abnormalities were noted in 68.4%. Polycystic ovaries (40.8%), endometriosis (23.7%), and pelvic adhesions (13.2%) were the most common findings. Following evaluation and appropriate surgical management, an overall conception rate of 59.2% was achieved. Women with endometriosis demonstrated lower conception rates compared with those without endometriosis.

Conclusions Combined hystero-laparoscopy remains a valuable diagnostic and therapeutic modality in infertility, particularly in women with unexplained infertility or suspected pelvic pathology. The procedure enables detection and correction of abnormalities that may not be identified through routine investigations and is associated with favourable reproductive outcomes.