Hysterolaparoscopy in assessment and management of female infertility

Abstract

Background: Female infertility is a growing matter of concern in reproductive age affecting approximately 80 million couples globally. As per WHO, infertility prevalence in India is up to 16.8%. Aims: The present trial was carried out to assess the pathologies in the reproductive tract of females with primary/secondary infertility using hysterolaparoscopy and to narrate the therapies for management used in subjects depending on findings of the hysterolaparoscopy. Materials and Methods: The study included 40 females within reproductive age of 18 years to 49 years diagnosed with either primary or secondary infertility that underwent under general anesthesia, hysterolaparoscopy was done to detect any abnormality, and the subjects were kept under observation post-operatively for 1 day. The collected data were subjected to the evaluation and the results were formulated. Results: Laparoscopic abnormalities were seen in 35% (n = 140) subjects, Hysteroscopic abnormalities in 12.5% (n = 5) subjects, and combined in 15% (n = 6) subjects. Depending upon the underlying pathology detected on hysterolaproscopy, various interventions were performed in the study subjects (Table 4) including ovarian drilling (25%, n = 10), ovarian cystectomy (25%, n = 10), polypectomy (15%, n = 6), curettage (2.5%, n = 1), adhesiolysis (15%, n = 6), myomectomy (2.5%, n = 1), cannulation (2.5%, n = 1), fulgration (2.5%, n = 1), and salpingectomy (7.5%, n = 3). Conclusion: Within its limitations, the present study concludes that laparoscopy increases the accuracy of abnormality detection. Also, concurrent use of laparoscopy with hysteroscopy leads to better results in terms of cost, post-operative healing, and detection of abnormalities in females with infertility.