Prevalence of Pelvic Pathology in Patients of Female Infertility Using Diagnostic Laparohysteroscopy in a Tertiary Care Hospital of North India

Abstract

Background: Female infertility is a multifactorial condition, and accurate detection of pelvic and intrauterine pathology is essential for effective management. Diagnostic hysterolaparoscopy provides direct visualization of reproductive organs and may identify abnormalities missed by conventional imaging.

Objectives: To determine the prevalence and pattern of pelvic and intrauterine pathologies in women with infertility using diagnostic hysterolaparoscopy and to compare its diagnostic yield with ultrasonography.

Materials and Methods: This hospital-based cross-sectional study was conducted in the Department of Obstetrics and Gynecology at a tertiary care hospital in North India over 18 months. Sixty-four women with primary or secondary infertility underwent diagnostic hysterolaparoscopy. Clinical data, ultrasonographic findings, and endoscopic findings were recorded and analyzed using SPSS. Results were expressed as frequencies, percentages, and mean ± SD, with p < 0.05 considered statistically significant.

Results: The mean age of patients was 30.1 ± 7.5 years, with primary infertility seen in 75% of cases. Diagnostic hysterolaparoscopy detected abnormalities in 73.4% of patients, compared to 65.6% detected by ultrasonography. Common laparoscopic findings included pelvic endometriosis (17.2%) and pelvic adhesions (17.2%), while hysteroscopy most frequently revealed abnormal endometrium (29.7%) and uterine polyps (18.8%). Many pathologies were identified despite normal ultrasonographic findings.

Conclusion: Diagnostic hysterolaparoscopy has a high diagnostic yield in the evaluation of female infertility and is superior to ultrasonography in detecting pelvic and intrauterine pathologies. Its early use allows comprehensive assessment and facilitates timely therapeutic intervention.