Role of Hystero-laparoscopy in Infertility
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Abstract
Background: One of the most frequent issues for which a couple seeks medical help is infertility. Unfortunately, standard clinical examinations and ultrasounds frequently overlook a number of illnesses that impair female fertility. We looked at the prevalence of different medical disorders that affect the female reproductive system and cause infertility. The effectiveness of hystero-laparoscopy as a diagnostic and treatment technique for infertility was evaluated, and patients’ subsequent fertility was examined.
Material and methods: This is a retro-prospective descriptive study carried out on 75 infertility patients undergoing diagnostic hysterolaparoscopy in a tertiary care hospital from Jan 2017 to October 2019. This study was approved by the ethical committee. Primary parameters in terms of the prevalence of various pathological conditions leading to infertility were assessed. Secondary parameters in terms of fertility outcome after hysterolaparoscopy were studied.
Result: Adhesions were the most common findings (28%) followed by fibroid (16%), cyst (14.7%), PCOS and Endometriosis (8% each), tubal blockade (6.7% each unilateral and bilateral), unicornuate uterus and arcuate uterus with tubal block (2.7% each) and bilateral to mass (1.3%) respectively. A total of 69 (92%) patients underwent therapeutic hysterolaparoscopic procedures. Ovulation induction (48%) was the most common post-intervention (hysterolaparoscopy) treatment followed by in vitro fertilization (21.3%) and Ovulation induction with intra-uterine insemination (13.3%). No postintervention treatment was offered to 13 patients (17.3%) out of which spontaneous conception was achieved in 6 patients. Overall, the conception success rate was 40%.
Conclusion: The findings of the study showed that hystero-laparoscopy was useful in finding out the cause of infertility in a large proportion of women. It was also useful in simultaneously offering the appropriate intervention depending upon underlying pathology. The use of hysterolaparoscopy followed by post-intervention infertility treatment was useful in achieving conception.
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