Published: 2019-04-26

Role of diagnostic hysterolaparoscopy in the evaluation of female infertility

Madhuri N., Rashmi H. S., Sujatha M. S., Dhanyata G.


Background: Infertility is defined by WHO as a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. The prevalence of infertility is about 10%-15% of reproductive age couples. Female factor is responsible for 40-45% of etiology of infertility. Aim of the study was to evaluate the role of diagnostic hysterolaparoscopy in female infertility at a tertiary care centre.

Methods: This is a retrospective hospital based study done at a tertiary care hospital attached to JSS Medical College, Mysuru between January 2017 and December 2018. Infertile women with primary or secondary infertility in the 18-40 years age group, with normal hormonal profile and no known male factor were included.

Results: In our study, primary infertility was found in 77% of the 96 patients and secondary infertility was found in 23% of patients. In primary infertility, ovarian pathology was the most common finding while Endometriosis was the most common finding in secondary infertility group. 77 % patients were found to have bilaterally patent tubes while remaining had unilateral or bilateral blockage. On hysteroscopy, endometrial polyps were the commonest hysteroscopic finding in both groups.

Conclusions: Combined hystero-laparoscopy is a safe, effective and reliable method in comprehensive evaluation of infertility. It helps in the diagnosis of pelvic pathology which may have been missed by routine examination and thereby helps in optimal management of female infertility.


Hysteroscopy, Infertility, Laparoscopy

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Chanu SM, Rudra Pal GS, Panda S, Santa Singh AS. Diagnostic hysterolaparoscopy for evaluation of infertility: Our experience in a tertiary Care Hospital. J Hum Reprod Sci. 2018;11:19-23.

Sarkar S, Gupta P. Socio-demographic correlates of women's infertility and treatment seeking behavior in India. J Reprod Infertil. 2016;17(2):123-32.

Ganguly S, Sayeed U. Trends of Infertility and Childlessness in India: Findings from NFHS Data. Facts, views and vision in Ob Gyn. 2010;2:131-8.

Miller JHN, Weinberg RK, Canino NL, Klein NA, Soules MR. The pattern of infertility diagnosis in women of advanced reproductive age. Am J Obstet Gynecol. 1999;181:952-7.

Roupa Z, Polikandrioti M, Sotiropoulou P, Faros E, Koulouri A, Wozniak G, et al. Causes of infertility in women at reproductive age. Heal Sci J. 2009;3(2):80-7.

Pal M, Devgun P, Chalana H, Kaur H, Biswas A, Sen S. A study of prevalence and socio-demographic profile of infertile couples in field practice area of a tertiary care centre, Amritsar, Punjab, India. Int J Comm Med Pub Heal. 2017 Jan 5;3(6):1472-6.

Ramesh B, Kurkuri SN. The role of combined hystero-laparoscopy in the evaluation of female infertility as one step procedure: a retrospective analytical study of 250 patients. Int J Reprod Contracept Obstet Gynecol. 2016;5:396-401.

Nayak PK, Mahapatra PC, Mallick J, Swain S, Mitra S, Sahoo J. Role of diagnostic hysterolaparoscopy in the evaluation of infertility: A retrospective study of 300 patients. J Hum Reprod Sci. 2013;6(1):32-4.

Nanaware SS, Saswade M, Shende PN, Gaikwad P, Mahana S, Kirane A. Role of hysterolaparoscopy in the evaluation of female infertility in tertiary care centre. Int J Contem Med Res. 2016;3(10):3063-5.

Kabadi YM, Harsha B. Hysterolaparoscopy in the evaluation and management of female infertility. J Obstet Gynaecol India. 2016;66(Suppl 1):478-81.

Hinckley MD, Milki AA. 1000 office-based hysteroscopies prior to in vitro fertilization: Feasibility and findings. JSLS. 2004;8:103-7.

Shalev J, Meizner I, Bar-Hava I, Dicker D, Mashiach R, Ben-Rafael Z. Predictive value of transvaginal sonography performed before routine diagnostic hysteroscopy for evaluation of infertility. Fertil Steril. 2000;73:412-7.

Al Chami A, Saridogan E. Endometrial Polyps and Subfertility. J Obstet Gynaecol India. 2016;67(1):9-14.

Shokeir TA, Shalan HM, EI-Shafei MM. Significance of endometrial polyps detected hysteroscopically in eumenorrheic infertile women. J Obstet Gynaecol Res. 2004;30:84-9.

Practice Committee of the American Society for Reproductive Medicine in collaboration with The Society of Reproductive Surgeons. Myomas and reproductive function. Fertility and Sterility. 2008 Nov 1;90(5):S125-30.

Practice Committee of the American Society for Reproductive Medicine. Uterine septum: a guideline. Fertility Sterility. 2016;106(3):530-40.

Practice Committee of the American Society for Reproductive Medicine. Endometriosis and infertility: a committee opinion. Fertility Sterility. 2012;98(3):591-8.

Missmer SA, Hankinson SE, Spiegelman D, Barbieri RL, Marshall LM, Hunter DJ. Incidence of laparoscopically confirmed endometriosis by demographic, anthropometric, and lifestyle factors. American J Epidemiol. 2004 Oct 15;160(8):784-96.

Practice committee of American Society for Reproductive Medicine. Diagnostic evaluation of infertile female: a committee opinion Birmingham, AL: American Society for Reproductive Medicine. Fertil Steril. 2015;103:e44-50.

Papaioannou S, Bourdrez P, Varma R, Afnan M, Mol BW, Coomarasamy A. Tubal evaluation in the investigation of subfertility: a structured comparison of tests. BJOG: An Int J Obst Gynaecol. 2004 Dec 1;111(12):1313-21.