International Journal of Health and Clinical Research
Yazarlar: Apurba Mandal, Kajal Kumar Patra, Shibram Chattopadhyay, Arunava Biswas, Md. Abdul Hadi, Poulami Samanta, Shritanu Bhattacharyya
Konular:-
Anahtar Kelimeler:Primary infertility,Secondary infertility,Hysterosalpingography,Laparoscopy,Hysteroscopy,Lap dye test (Chromopertubation)
Özet: Introduction: Infertility affects about 10-15% of reproductive age couple and its increasing globally. Intraperitoneal pathology is responsible for 40-50% cases of infertility. The ability to visualize and treat the identifying pathology of uterus, fallopian tubes and ovaries during hysteroscopy is an essential part of infertility evaluation. Objective: To study the prevalence of different causes of female infertility, diagnosis and treatment of infertility by combined hysteron-laparoscopy. Materials & Methods: Out of 220 patients who attended the infertility clinic, 200 infertile patients were included after fulfilling the inclusion and exclusion criteria in the study done over a period of 12 months from 1st April 2018 to 31 March 2019 in the Department of Gynecology at a tertiary care hospital in eastern India.Combined hysterolaparoscopy was performed and the observations were recorded followed by interventions as required was performed and noted. Results: The age range of the study participants were between 20-40 years. Primary infertility was seen in 118 out of 200 cases (59%) while rest 82 patients (41%) presented with secondary infertility. Diagnosis of abnormal pathology by hysteroscopy was made in 29 cases (24.6%) in primary infertility and in 20 cases (24.4%) in secondary infertility. By laparoscopy, pathological causes of infertility were found in 64 cases (54.2%) of primary infertility while in 34 cases (41.5%) of secondary infertility showed abnormal findings. Submucosal fibroid 6(5.1%), uterine septum 2 (1.7%), cornual block 15 (12.7%), polyp 4 (3.4%), synechiae 3(2.5%) were the commonest hysteroscopic findings of primary infertility. Endometritis 5 (6.1%), submucous fibroid 5 (6.1%), cornual block 12(14.6%), synechiae 4 (4.9%), polyp 2 (2.4%) were commonest hysteroscopic findings of secondary infertility. Endometriosis 37 (31.4%), fibroid 14 (11.9%), pelvic adhesions 15 (12.7%), PCOS 21 (17.8%), UTB 21 (17.8%), BTB 20 (16.9%) were prevalent findings in laparoscopy in primary infertility while the lap findings in secondary infertility were PCOS 31 (37.8%), endometriosis 23 (28%), UTB 17 (20.7%), pelvic adhesions 11 (13.4%). Conclusion: Combined Hysterolaparoscopy is an effective and reliable method in comprehensive evaluation of female infertility.