Should diagnostic hysteroscopy and diagnostic laparoscopy be a combined primary work up in evaluating primary & secondary infertile women?

Abstract

The aim of this study was to clarify the role of simultaneous combined diagnostic approach using laparoscopy and hysteroscopy in the primary evaluation of female infertility. Also to study its significance in etiopathology of primary and secondary infertility.Materials and Methods: In a prospective study of 100 infertile female, patient were thoroughly examined, evaluated & underwent Hysterolaparoscopy as a primary work up. Patient divided into 2 categories 50 patient of primary infertility & 50 patients as 20 infertility Results: In this study it was found that tuberculosis (TB) were present in 7 patients of primary (10) & 2 patients of secondary (20) infertility. Pelvic adhesions were found in 7 patients of 10 & 5 patients of 20 infertility. Bilateral tubal black seen in 4 patients of 10, none of the patient of 20 infertility were found to have bilateral tubal block. Unilateral tubal block – seen in 4 patients of 10 & 2 patients of 20 infertility Also on hysteroscopy uterine anomalies were present in 3 patients of 10 & 5 patient of 20 which includes Arcuate, Bicarnuate, unicornuate, Septate uterus. Submucous fibroid were found in 1 patient of 10 & 3 patient of 20 infertility. Hysterolaparoscopy plays very important role as diagnostic tool in the infertile women.Also, diagnostic hysteroscopy has significant role in the evaluation of the cause of female infertility both primary & secondary. Furthermore hysterolaparoscopy can be used simultaneously for treatment of any pathological condition like septal resection, polycystic ovary drilling, fimbrial block & many more. However, one can rarely expect to find the definite underlying reason for infertility in all other methods of evaluation.Conclusion: We consider combined laparoscopy and hysteroscopy to be the most important procedures in the evaluation of female infertility & combined diagnostic laparoscopy and hysteroscopy should be performed in all infertile patient of primary & secondary infertility before subjecting her for further treatment.