COMBINED DIAGNOSTIC APPROACH OF HSG AND DIAGNOSTIC HYSTEROLAPAROSCOPY IN EVALUATION OF FEMALE INFERTILITY.
- Department Of Obstetrics & Gynaecology, S.C.B. Medical College & Hospital, Cuttack, Odisha, India.
- Abstract
- Keywords
- References
- How to Cite This Article
- Corresponding Author
Background: Since the history of mankind, human infertility has been a source of personal misery and social stigma. The aim of the present study is to assess the combined diagnostic approach of HSG and DHL in the evaluation of female infertility both primary and secondary and to identify the incidence of the various pathological conditions in the female reproductive tract leading to infertility and to study the advantages of diagnostic hysterolaparoscopy over hysterosalpingography. Method: The present study is a prospective observational study, conducted in the department O & G, SCBMCH, Cuttack. One hundred infertile patients were included in this study. All patients underwent both HSG and DHL. The standard protocols for HSG and DHL were followed. All reports on the 100 selected patients were reviewed. Result:In our study, 68% patients are in primary infertility and 32% in secondary infertility. Maximum number of patients with primary infertility were in the age group of 26- 30 years i.e. 50% and 56.3% in secondary infertility. Tubal pathologies were the commonest of all followed by filling defects like myoma, polyps, synechiae and uterine anomalies in both HSG and DHL in both the primary and secondary infertility groups. Surgical interventions were done in 84% of primary infertility cases and in 97% of secondary infertility cases. The therapeutic measures were taken like polypectomy, myomectomy, septum resection during hysteroscopy. Most commonly done procedure in this study was adhesiolysis in 22 ? 24% of cases followed by cannulation in15-22% cases. Conclusion: Our study found that Hysterosalpingography is simple, inexpensive, safe and rapid diagnostic modality for tubal patency then laparoscopy. Laparoscopy is considered the Gold Standard for diagnosing tubal and peritoneal disease. HSG and Laparoscopy are not alternative, but complimentary to each other but hysterolaparoscopy is more informative and operative intervention can be done in the same sitting.
- Boivin J, Bunting L, Collins JA, Nygren KG. International estimates of infertility prevalence and treatment-seeking: Potential need and demand for infertility medical care. Hum Reprod. 2007;22:1506- 12.
- Padubidri VG, Daftary SN. Shaw?s Text Book of Gynecology, 14th edition, Reed Elsevier India pvt- Ltd; 198.
- Fritz MA, Speroff L. Clinical Gynecology Endocrinology and Infertility, 8th edition, chapter 27; 1137.
- World Health Organization 2013. \"Health Topics: Infertility\". Available?http://www.who.int/topics/infertility/en/. Retrieved November 5, 2013.
- World Health Organization 2013.\"Sexual and reproductive health: Infertility definitions and terminology.Available?http://www.who.int/reproductivehealth/topics/infertility/definitions/en/.RetrievedNovember 5, 2013.
- Rutstein, Shea O., and Iqbal H. Shah. \"Infecundity, Infertility, and Childlessness in Developing Countries.\" DHS Comparative Reports No. 9 (2004): 1-57
- Shamila S, Sasikala SL. Primary Report on the Risk Factors Affecting Female Infertility in South Indian Districts of Tamil Nadu and Kerala. Indian J Community Med. 2011;36(1):59-61.
- Berek JS, Rinehart RD, Hillard PA, Adashi EY. Novak?s Gynecology, 15th edition, Walters Kluwer India Pvt Ltd, chapter 32; 1139.
- Dutta DC. Text Book of Gynecology, 6th edition, New Central Book Agency pvt Ltd. Chapter 10; 136 ? 7.
- Crosignani PG, Rubin BL. The ESHRE Capri Workshop Group. 2000. Optimal use infertility diagnostic tests and treatments. Human Reprod. 2000;15:723-32.
- Lessey BA, Forstein DA, Miller PB, Egbuniwe MN, Dodds R. Laparoscopic surgery improves outcome and diagnostic accuracy in unexplained infertility. FertilSteril. 2010;94:S38.
- Nayak PK, Mahapatra PC, Mallick JJ, Swain S, Mitra S, Sahoo J. Role of diagnostic hystero-laparoscopy in the evaluation of infertility: A retrospective study of 300 patients. J Hum Reprod Sci. 2013;6:32-4.
- Makled AK, Farghali MM, Shenouda DS. Role of hysteroscopy and endometrial biopsy in women with unexplained infertility. Arch Gynecol Obstet. 2014;289:187-92.
- Jayakrishnan K, Koshy AK, Raju R. Role of laparohysteroscopy in women with normal pelvic imaging and failed ovulation stimulation with intrauterine insemination. J Hum ReprodSci 2010;3:20-4.
- Goynumer G, Yetim G, Gokcen O et al. Hysterosalpingography, Laparoscopy or both in the Diagnosis of Tubal Disease in Infertility. World Journal of Laparoscopic Surgery, 2008 May-Aug; 1(2):23?6.
- Foroonzanford F, Sadat Z. Diagnostic Value of Hysterosalpingography and Laparoscopy for tubal patency in infertile women. Nurs Midwifery Stud. 2013; 2(2):188? 92.
- Neerja JK et al. Comparitive Status of Hysterosalpingography and laparoscopy in evaluation of Infertile Women. Journal of Advance Research in Biological Sciences. 2012; 4(10):41? 3.
- Heis M, Amarin Z et al. Uterine and Tubal anatomical abnormalities in infertile women: diagnosis with routine hysterosalpingography prior to selective laparoscopy. SA Journal of Radiology. 2011 Dec; 121?2.
- Mol BWJ, Collins JA, Burrows EA, van der Veen F et al. Comparison of hysterosalpingography and laparoscopy in predicting fertility outcome. Human Reproduction. 1999; 14(5):1237?42.
- Behuria S, Nayak R. Diagnostic and therapeutic hysterolaparoscopy in evaluation and treatment of female infertility in a tertiary hospital. Int J ReprodContraceptObstetGynecol 2016;5: 4189-92.
- Samipa J. Shah, Dr. Akshay C. Shah et al. NHL Journal of Medical Sciences/July 2014/Vol 3/Issue 2.
- Kamiński P, Wieczorek K, Marianowski L. Usefulness of hysteroscopy in diagnosing sterility Ginekol Pol.1992;63:634-7.
- Donnez J, Jadoul P. What are the implications of myomas on fertility? A need for a debate? Hum Reprod.2002; 17:1424-30.
- Pritts EA. Fibroids and infertility: A systematic review of the evidence. ObstetGynecolSurv. 2001;56:483-91.
- Agrawal N, Fayyaz S. Evaluation of endoscopic procedures in terms of achieving pregnancy in female infertile patients: An experience at a single tertiary care center. J GynecolObstet Hum Reprod. 2018 Nov;47(9):
- Vaid K, Mehra S, Verma M, Jain S, Sharma A, Bhaskaran S. Pan endoscopicapproach \"hysterolaparoscopy\" as an initial procedure in selected infertilewomen. J ClinDiagn Res. 2014 Feb;8(2).
- Kabadi YM, Harsha B. Hysterolaparoscopy in the Evaluation and Management of Female Infertility. J ObstetGynaecol India. 2016 Oct;66(Suppl 1):478.
- Chanu SM, Rudra Pal GS, Panda S, Santa Singh A S. Diagnostic hysterolaparoscopy for evaluation of infertility: Our experience in a tertiary Care Hospital. J Hum ReprodSci [serial online] 2018 [cited?2019 Apr 1];11:19-23.
Sujata Singh, Lucy Das, Swarnima Das ,Pravat Chandra Das. (2019); COMBINED DIAGNOSTIC APPROACH OF HSG AND DIAGNOSTIC HYSTEROLAPAROSCOPY IN EVALUATION OF FEMALE INFERTILITY., Int. J. of Adv. Res., 7 (08), 623-630, ISSN 2320-5407. DOI URL: https://dx.doi.org/10.21474/IJAR01/9543
Department Of Obstetrics & Gynaecology, S.C.B. Medical College & Hospital, Cuttack, Odisha, India






