Infertility/IVF Clinic

Female Internal Genital Organs

Cause of Female Infertility

Should Hysteroscopy be a routine procedure in infertile women

Dr. Sharda Jain
Dr. Jyoti Agarwal

• <Aims and Objectives: To evaluate the role of hysteroscopy in the evaluation of female infertility.
• <Material and Methods: This was a prospective study done in Life Care Centre: Super Speciality Gynae Clinic. The records of 110 patients were studied prospectively.
• <Result: Out of 110 patients 79 were found to have normal findings on hysteroscopy. Hysteroscopy showed abnormal findings in 21 patients (19%).
• <Hysteroscopy findings – submucous fibroid in 3 patients (2.7%) myomectomy done, endometrial polyp in 4 (3.6%) polypectomy done, intrauterine fibrosis and adhesions in 7 (6.36%) Cu-T put in 4 cases, cornual block in 7 (6.36%) successful cannulation done in 3 cases, hysteroscopy failed in 1 case as office procedure.
• <Conclusion: Hysteroscopy should be recommended as a routine in infertility cases as the abnormalities discovered can be treated simultaneously thereby increasing the changes of conception. Small endometrial polyp and intrauterine adhesions are invariably missed on Transvaginal Sonography

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Should Laparoscopy be a routine procedure in infertile women

Dr. Sharda Jain

Dr. Jyoti Agarwal

In our earlier prospective study of 100 cases of infertility taken for Diagnostic Laparoscopy in 1998-2000, in 72% there was normal laparoscopy finding.

Since then, we rely more on Transvaginal Sonography and do not subject all cases routinely for Diagnostic Laparoscopy and increase the case of investigations.

The second prospective study done from January 2006 to December 2008. 52 cases with abnormal TVS were evaluated by laparoscopy.

Abnormal findings were found in 48 patients. Only in 4 cases the findings were normal.

Abnormal laparoscopy findings were as follows:

B/L tubes were blocked with large hydrosalpinx in 5 (salpinjectomy done in 2 cases and clipping in 2 cases); Unilated tubal occlusion in 5 (Tuboplasty done in all) Pelvic adhesions in 12, (satisfactory adhesiolysis done); Myomas in 5 (myomectomy done in 2 cases); Endometriosis in 8 cases; ovarian cyst in 6 (cystectomy done in all), evidence of tuberculosis seen in 2, PCOS found in 7 cases (drilling done in 3 cases). Out of these 52 cases, 27 patients have already conceived.

Conclusion: Laparoscopy is recommended in all cases where there is abnormal findings at Trans Vaginal Sonography. In such cases of infertility, the abnormalities discovered rate as very high (9.90%) cases can be treated simultaneously thereby increasing the changes of conception