Application of hysteroscopy combined with laparoscopic pelvic exploration in the diagnosis and treatment of primary and secondary infertility

Abstract

Objective To observe the different manifestations and differences of pelvic laparoscopy in primary and secondary infertility patients, and to clarify the application of hysteroscopy combined with laparoscopy in the diagnosis and treatment of infertility. Methods A total of 120 infertile women were enrolled in Yiwu Central Hospital from January 2015 to January 2017, of which 66 cases were primary infertility and 54 cases were secondary infertility. The infertility group was divided into 1 time, 2 times, 3 times and above according to previous maternity. Hysteroscopy combined with laparoscopy was used for pelvic exploration in infertility patients. The detection of the type of disease, pelvic adhesions, tubal fluid and treatment were analyzed. Results (1)Infertile patients were complicated with endometriosis, pelvic tuberculosis, polycystic ovary, uterine fibroids, ovarian tumors, endometrial polyps and other diseases. (2)There were 94 cases of pelvic adhesions(78.3%), 50 cases of primary infertility(75.8%), and 44 cases in Secondary infertility group(81.5%). (3) Primary infertility adhesion ratio of 75.8%, secondary infertility adhesion ratio of 81.5%, the proportion of adhesions in maternal 1 time patients was 80.6%, the proportion of adhesions in pregnant women with 2 times was 83.3%, the proportion of adhesions in pregnant women with more than three times was 90.0%, and the median adhesion rate was 36.4% in the secondary infertility cases, the proportion of severe adhesion was 45.5%. (4) Intraoperative treatment of tubal fluid examination conducted in 240 strips.The probability of recanalization of the primary infertility group was 17.78%, and the probability of recanalization was 18.75%. Conclusion (1) Pelvic adhesion is an important factor in causing infertility, primary infertility patients also have a greater proportion of pelvic, fallopian tube disease.(2) Repeated maternal history significantly increased pelvic, fallopian tube disease, which is an important factor caused the increased incidence of secondary infertility. Key words: Infertility, female; Hysteroscopy; Laparoscopy; Tissue adhesions; Pelvic inflammatory disease; Fallopian tube diseases