Publication:

Role of combined hystero-laparoscopy in the evaluation of female infertility as one step procedure: a retrospective analytical study of 250 patients

Background Infertility is defined as a failure of a couple to conceive after having regular, unprotected sexual intercourse for one year. To determine the role of combined hystero-laparoscopy in the evaluation of female infertility patients with no significant clinical/ ultrasonography findings and to calculate the incidence of various pathological conditions in the female reproductive tract leading to infertility.

Methods This retrospective analytical study was done in 250 patients with primary and secondary infertility. It was conducted at our hospital from December 2014 to November 2015. We assessed the role of combined hystero-laparoscopy female infertility patients with no significant clinical/ ultrasonography findings and calculated the incidence of various pathological conditions in the female reproductive tract leading to infertility.

Results Out of 250 patients, 165 had primary and 85 had secondary infertility. The patients in secondary infertility group were older compared to primary group. The most common intrauterine pathology in both the groups was uterine septum. Next most common intrauterine lesion was endometrial polyp. Adnexal adhesions and endometriosis were the most common abnormalities detected in laparoscopy in both groups. The prevalence of unilateral and bilateral tubal block was almost equal in both groups. The operative interventions, both hysteroscopic and laparoscopic were also noted.

Conclusions Combined hystero-laparoscopy is a safe, effective and reliable method in comprehensive evaluation of female infertility. It is a very useful tool in detecting the correctable missed pelvic abnormalities in patients with the normal ovulation and semen analysis. It will also help us to take decision regarding the need for ART in required patients, thus avoiding further emotional and financial trauma to the couples.