Evaluation of Infertility Cases Attending Tertiary Care Centre with Hystero-Laparoscopy

Background: Infertility affects about 10 –15% of reproductive-age couples. The diagnosis and treatment of this disorder stands out as one of the most rapidly evolving area in the medicine.The majority of pelvic pathology in infertile women is frequently not well appreciated by routine pelvic examinations and the usual diagnostic procedures. The ability in visualizing the uterine cavity, fallopian tubes, ovaries and identifying the possible pathology during laparoscopy and hysteroscopy has made it an essential part of infertility evaluation and therapeutic procedures can also be done in the same sitting. Objectives: Primary objective is to evaluate the role of hystero-laparoscopy in Study of primary and secondary infertility. To identify incidence of various pathological conditions in female reproductive tract leading to primary and secondary infertility. Second objective is to understand the role of hystero-laparoscopy in Re- evaluation of already treated cases and its role in changing management plan. Material and Methods: A hospital-based observational study done on 60 infertile women attending the infertility department, who are included in the criteria were women of the reproductive age group(19-40yrs), not conceived despite of regular marital relationship with standard, typical, usualmale factors,also who got abnormal results in traditional investigations such as USG, Follicular Study, Sono-Hystero-Salpingography, and also Re-evaluation of treated cases and hystero-laproscopy is done in these patients. Results: Of the total 60 women, i n 23.5% cases of primary and 15.4% cases of secondary infertility there is no obvious pathology. Tubal pathology is seen in 5.9% and 23.1%cases of primary and secondary and ovarian pathology is seen in 35.3% and 26.9% cases of primary and secondary.Uterine pathology contributes to 38.2% and 38.5% of primary and secondary infertility. Endometriosis 11.8% and 7.7% respectively, tuberculosis to about 5.9% and 11.5% of primary and secondary, peritoneal factors 7.7% in secondary infertility. Therapeutic interventions are done in 43.3% and 50% by hysteroscopy and laparoscopy. Conclusion: Investigation of female infertility is incomplete without a hystero-la paroscopy, as all the exact etiology which may be of the ovarian, tubal, uterine, peritoneal, endometriotic, cervical, causes can be known, and in addition, treatment for these causes can also be offered in the same sitting.