Hysterolaparoscopy–‘See and Treat’ Infertility, is a Reality in Modern Gynaecological Practice

Abstract

Background: : The quest to improve diagnostic and therapeutic capabilities has led to the widespread acceptance of modern gynaecological endoscopy. Hysterolaparoscopy is a basic skill in the advanced scientific era and an effective and safe tool in comprehensive evaluation of infertility with an added advantage of treatment of some pathologies in same sitting. Methods: This clinical study is a prospective study of 100 selected cases of infertility. Patients who fulfills the inclusion and exclusion criteria were subjected to diagnostic laparoscopy and hysteroscopy in NIMS Infertility and Research centre, Jaipur over a period of one and half years from Jan 2014 ‐ June 2015. Observation of pelvic and intrauterine cavity and chromopertubation test was done under general anaesthesia during hysterolaparoscopy. Surgical interventions were carried out whenever required and further treatment plan was decided. Results: A total of 100 women underwent hysterolaparoscopy. Age ranged from 21 to 40 years and mean age was 30.03 years. Prevalence of primary infertility was 64% and of secondary infertility was 36%. Among cases with primary infertility commonest pathology responsible were ovarian 20 (31.25%) followed by unexplained 19 (29.69%), uterine 11 (17.18%), tubal 8 (12.50%) and peritoneal 8 (12.50%) whereas in secondary infertility commonest pathology responsible were uterine 14 (38.88%), followed by tubal 13 (36.11%), peritoneal 9 (25%), ovarian 8 (22.22%) and unexplained being the least 2(5.55%). Therapeutic procedures were performed in the same sitting amongst 84.61% cases with primary infertility and 92% cases with secondary infertility.Conclusion: When done by experienced hands, with proper selection of patients, hysterolaparoscopy is an indispensable tool which can be considered as a definitive day care procedure for evaluation and treatment of female infertility.