Combined laparoscopy and hysteroscopy in the investigation of infertility

ABSTRACT

100 women with primary or secondary infertility were included in this study. On hysteroscopic examination there were 18 cases with intrauterine abnormalities [18%], 5 patients with intrauterine adhesions, 4 with submucous myoma, one with endometrial polyp, 5 with uterine malformation and 3 cases with polypoid endometrium. Hysteroscopy, compared to HSG, revealed more abnormalities of the uterine cavity. There was complete agreement between both methods in 86 cases [86%], while the findings were different in 14 cases [14%]. Laparoscopic examination revealed 41 cases with pelvic abnormalities with incidence of 41.1%. There was complete agreement between HSG and laparoscopy in 70 cases [70.7%]. Laparoscopy was found superior to HSG in the detection of pelvic adhesions as 27 cases [27.2%] were diagnosed by diagnostic laparoscopy, while only 10 cases [10.1%] were suspected by HSG. On combined hysteroscopy and laparoscopy, it was found that, laparoscopy revealed abnormalities in 41%. This increased to 46% when hysteroscopy was added