Publication:

Hysterolaparoscopy in the evaluation and management of female infertility

Background To study the role of hysterolaparoscopy in the evaluation and management of female infertility.

Methods A retrospective study of the 677 case files of all the patients who underwent diagnostic hysterolaparoscopy for infertility between January 2011 to December 2016 at Karnataka Institute of Medical Sciences, Hubli and Sushruta Multispeciality hospital, Hubli. These infertile women were confirmed to have normal ovulatory cycles, hormonal assays and seminogram report. Dye studies as well as inspection for abnormal pelvic and intrauterine pathology and necessary therapeutic interven-tions were done during the procedure. Abnormal pelvic and intrauterine pathology by hysterolaparoscopy were categorized.

Results Out of 677 cases, 74% patients had primary, 26% patients had secondary infertility. As a whole pelvic pathology was confirmed in 59.5% and intrauterine pathology in 22.3% patients by hysteroscopy. The most common laparoscopic abnormality detected was Polycystic ovaries (27.1%), followed by pelvic adhesions (18.7%). Tubal block comprised 8.1% whereas distorted uterus by fibroid in 6.2% and pelvic endometriosis in 8.7%. In hysteroscopy, the incidence of uterine anomaly was 54 (7.9%). Septate uterus is the most common with a mean incidence of approximately 37 (67.8%).

Conclusions Diagnostic hysterolaparoscopy is an effective diagnostic and therapeutic modality for certain significant and correctable abnormalities in pelvis, tubes and uterus which are missed by other imaging modalities.