Diagnostic Hysterolaparoscopy in the Evaluation of Female Factor Infertility: A Cross-sectional Study at a Tertiary Care Hospital in Central India

Abstract

Background: Infertility is a worldwide problem affecting people of all geographical location and socioeconomic status. It is estimated that globally 60-80 million couples suffer from infertility every year. The main objective of the study is to detect the diagnostic efficacy of hysterolaparoscopy in evaluating the tubal, uterine, ovarian, and pelvic pathologies causing infertility and also compare the findings of a hysterosalpingogram with diagnostic laparoscopy in evaluating the tubal factor infertility. Materials and methods: This hospital-based cross-sectional study included an evaluation of 1,456 couples presenting with complaints of infertility at the Outpatient Department of Government Medical College, Nagpur during the period of February 2016 to September 2018. After thorough gynecological examination and investigations, 130 infertile women were posted for diagnostic hysterolaparoscopy. All the data were collected on predesigned proforma and the results were tabulated and raw percentages calculated to describe the results. Results: Among the 130 infertile women, 102 women (78.46%) had primary and 28 (21.53%) had secondary infertility. The maximum number of patients belonged to the age group of 26-30 years (39.23%). About 56% of patients were in the active marriage life of 3-5 years duration. Most of them had multiple factors affecting their fertility. Out of the 130 infertile women, 32 patients (24.62%) had uterine factors, 44 patients (33.84%) had peritoneal factors, 67 patients (51.5%) had ovarian factors, and 89 patients (68.46%) had tubal factors. Only eight patients (6.15%) had normal findings in laparoscopy. Out of the 130 patients, 122 (93.84%) had more than one factor causing infertility. About 26.15% of patients had positive findings in diagnostic hysteroscopy. Conclusion: Hysterolaparoscopy provides both a panoramic view of the pelvic reproductive anatomy and also a magnified view of the pelvic organs and peritoneal surfaces. It is generally regarded as the most reliable tool in the diagnosis of tubal pathology and other intra-abdominal causes of infertility because of the correctable abnormalities like endometriosis, adnexal adhesions, and septate uterus which are usually missed, are usually identified that helps in formulating a specific plan of management.