Evaluation of Diagnostic Hysterolaparoscopy in Infertility Assessment

Infertility, an illness identified by the World Health Organization (WHO), is defined as the failure to achieve a clinical pregnancy after 12 months of regular, unprotected intercourse. In India, the prevalence of primary infertility ranges from 3.9% to 16.8%. Hysteroscopy has become an essential tool for diagnosing infertility that offers the direct visualization of the uterine cavity to identify any abnormalities. This study aimed to evaluate the effectiveness of diagnostic hysterolaparoscopy (DHL) in infertility assessments.

This retrospective observational study involved 150 women with a history of infertility, conducted from May 2022 to September 2023. Data on the participants' demographic characteristics and medical histories related to infertility were collected and organized using Microsoft Excel.

The findings revealed the following:

• Among the 150 patients who underwent DHL, 89 (59.33%) were diagnosed with primary infertility, while 61 (40.67%) had secondary infertility. 
• Laparoscopy revealed abnormalities in 35 (39.3%) of those with primary infertility and in 26 (42.6%) with secondary infertility. 
• Hysteroscopy identified abnormalities in 12 (13.4%) of the primary infertility group and 6 (9.83%) of the secondary infertility group. 
• The most common abnormalities detected were uterine synechiae, fibroids, and uterine septa, with a higher incidence of tubal obstructions noted in the primary infertility group.

To summarize, DHL is an effective technique for evaluating infertility, particularly in identifying adnexal adhesions, endometriosis, and uterine septa. It can also uncover various structural abnormalities in the uterus, fallopian tubes, and pelvic region, which can aid in developing appropriate treatment strategies. Hence, both diagnostic and therapeutic procedures can be performed by DHL during the same session.

Source: Anusha M, Katti K, Subbarayappa N, An observational study of diagnostic hysterolaparoscopy for evaluation of infertility at a tertiary care hospital. Indian J Obstet Gynecol Res 2024;11(4):553-557. https://doi.org/10.18231/j.ijogr.2024.099