scholarly journals Observational study of HSG with laparoscopic correlation in infertility patients

2018 ◽  
Vol 7 (5) ◽  
pp. 1903
Author(s):  
Avinash Dubbewar ◽  
Saumen Kanti Nath
Keyword(s):  
Predictive Value ◽  
Pregnancy Loss ◽  
Diagnostic Laparoscopy ◽  
High Sensitivity ◽  
Secondary Infertility ◽  
Tubal Patency ◽  
Primary Infertility ◽  
Appropriate Therapy ◽  
Infertility Patients ◽  
Recurrent Early Pregnancy Loss

Background: Uterine abnormalities contribute to 10% of infertility cases and 50% of women with recurrent early pregnancy loss whereas fallopian tube abnormalities contribute to 20% of such cases.Methods: Total 61 patients of infertility and subfertility undergoing evaluation and treatment at our centre were selected for HSG. Total 25 patients from this group have undergone diagnostic laparoscopy, their findings were correlated with HSG findings retrospectively.Results: All the patients in the study group were either primary or secondary infertility patients. Of the 61 patients of infertility, 49 were in primary infertility group and 12 were in secondary infertility group. The age of patients was between 23 and 35 years. The average duration of primary infertility was 5 years and secondary infertility was 3.5years. Total 61 patients underwent HSG, 42(68.8%) patients had normal findings and 19(31.14%) patients had abnormal findings. In abnormal findings 4(6.55%) were Mullerian abnormalities and 15(24.59%) were either unilateral or bilateral tubal block. Total 25 patients underwent diagnostic laparoscopy out of 61 patients. The sensitivity of HSG was 90% and specificity was 60 % with positive predictive value of 60% and negative predictive value of 90% as compared to diagnostic laparoscopy. Tubal block was defined as any form of tubal occlusion detected at HSG and finally confirmed on laparoscopy.  In our laparoscopy findings, peri-adnexal adhesions were found in 5 (20%) of the blocked tubes on laparoscopy. Endometriosis was detected in 1 (4%) of the blocked tubes and suspected intra-tubal block in 2 (8%).Pelvic inflammatory disease was found to contribute in 3 (12%).Conclusions: HSG demonstrates high sensitivity in our study. So, it should be used as the initial investigation for identifying uterine abnormality and tubal patency. As the specificity is less, we suggest that laparoscopy is necessary to recognize those cases of tubal block, which were unrecognized or wrongly recognized on HSG. In addition, the patients who were found to have tubal block on HSG, laparoscopy helps in finding the cause of infertility like existence of peritubal adhesions and endometriosis that can guide appropriate therapy. 

scholarly journals Diagnostic evaluation of tubal patency in a tertiary care hospital

2021 ◽  
Vol 9 (7) ◽  
pp. 1903
Author(s):  
Nikita Gandotra ◽  
Nivedita Prashar ◽  
Abhinav Sharma
Keyword(s):  
Predictive Value ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
High Sensitivity ◽  
Care Hospital ◽  
Secondary Infertility ◽  
Tubal Patency ◽  
Medical College ◽  
Appropriate Therapy ◽  
Tubal Pathology

Background: Infertility  has  always  been  one  of  the  most  elusive  symptom  complexes  that  perplex  the best gynecologists.  Amongst female factors, tubal factors are responsible for 25-30% of infertility. Hysterosalpingography and diagnostic laparoscopy with chromopertubation are widely used in the evaluation of tubal factors of infertility. Aim of the study was to compare hysterosalpingography and laparoscopy in the diagnosis of tubal patency in infertile patients.Methods: In this study 50 patients of infertility were evaluated prospectively in the Department of Obstetrics and Gynecology, Government Medical College, Jammu from April 2019 to March 2020. The findings of HSG and laparoscopy were compared.Results: Mean age at presentation for primary infertility was 28.6±4.20 years and for secondary infertility it was 32.1±3.84 years. Majority of patients of primary (77.6%) and secondary infertility (54.5%) had duration of infertility of 1-5 years in our study. The sensitivity of HSG was 90.91% and specificity was 77.78 % with positive predictive value of 83.33% and negative predictive value of 87.50%, when tubal pathology was defined as any form of tubal occlusion detected at laparoscopy, either one sided or two sided.Conclusions: HSG demonstrates high sensitivity in our study. So, it should be used as the initial investigation for identifying tubal patency. As the specificity is less, we suggest that laparoscopy is necessary to recognize those cases of tubal block which were unrecognized or wrongly recognized on HSG. In addition, the patients who were found to have tubal block on HSG, laparoscopy helps in finding the cause of infertility like existence of peritubal adhesions and endometriosis that can guide appropriate therapy.

A STUDY ON THE ROLE OF SALINE SONOSALPINGOGRAPHY AS A TEST FOR TUBAL PATENCY IN THE ASSESSMENT OF INFERTILITY

2021 ◽  
pp. 80-82
Author(s):  
Bishnu Prasad Das ◽  
Manoj Kumar Majumdar ◽  
Chumi Deka
Keyword(s):  
Predictive Value ◽  
High Sensitivity ◽  
Fallopian Tubes ◽  
Perfect Agreement ◽  
Tubal Patency ◽  
Primary Health ◽  
Infertility Patients ◽  
Work Up ◽  
Tubal Pathology

Background: Tubal pathology is one of the major causes of infertility and evaluation of fallopian tubes forms an essential part of work up of infertility patients. The aim of the study was to evaluate tubal patency by Saline Sonosalpingography and compare the results with that of hysterosalpingography. Methods: A total of 22 patients with primary infertility and 13 patients with secondary infertility attending our Obstetrics and Gynecology department were recruited for the study from July 2019 to June 2020. All the study subjects underwent Saline Sonosalpingography on day 7 to day 9 and Hysterosalpingography on 7th to 11th day of the menstrual cycle. Data was collected and compared to assess the sensitivity and specicity of Sonosalpingography with Hysterosalpingography as reference standard. Results: Sonosalpingography (SSG) has 98.18% sensitivity and 66.67% specicity in comparison to hysterosalpingography (HSG). Analysis of the raw data gave positive predictive value of 91.52% and negative predictive value of 90.9%. Near perfect agreement (Cohen's Kappa coefcient =0.9) was seen between the results of the two methods (SSG and HSG). Conclusions: Sonosalpingogrpahy has a high sensitivity for tubal patency and is less invasive. It is found to be a reliable and relatively less expensive diagnostic procedure in the management of infertility in females. Easy availability and accessibility of ultrasound in all primary health care centres denitely can prove superior to conventional method of diagnosis of tubal patency in such patient.

scholarly journals Laparoscopy: the tool for infertility

2017 ◽  
Vol 6 (12) ◽  
pp. 5544
Author(s):  
Neelima P. Shah ◽  
Prashant D. Shah
Keyword(s):  
Blue Dye ◽  
Secondary Infertility ◽  
Tubal Patency ◽  
Infertile Women ◽  
Primary Infertility ◽  
Therapeutic Laparoscopy ◽  
Therapeutic Value ◽  
Ovarian Pathology ◽  
Infertility Patients

Background: Most of the healthy couples conceive within a year after marriage. The infertility patients have become important part of clinical practice. Diagnostic and therapeutic Laparoscopy plays major role in the management of these cases. We investigated hale 50 infertile women with laparoscopy. This study was undertaken to ascertain the diagnostic and therapeutic role of Laparoscopy in female infertility.Methods: We evaluated 50 couples having infertility. The cases of primary and secondary infertility were evaluated. The laparoscopy was done under general anaesthesia. The pelvic organs were examined, and tubal patency was tested with chromo-perturbation by using Methylene blue dye. The findings were noted. The therapeutic intervention was done in the cases where it was necessary.Results: Total 50 cases of infertility were studied. Thirty were of primary infertility and 20 were of secondary infertility. The patients with primary infertility were younger with mean age of 20 years. The duration of infertility ranged from 1.5 to 8 years. We detected total 21 (42%) patients with ovarian pathology, 5 (10%) with tubal, four (8%) with peritoneal factor 3 (6%) with endometriosis. One patient had uterine fibroid and 16 (32%) cases had normal laparoscopic findings.Conclusion: This study supported the diagnostic and therapeutic value of laparoscopy in managing infertile women. It helped in detection of pelvic pathology. It also helped to plan further management in the form of IUI or IVF.

scholarly journals Evaluation of role of laparoscopy in determining etiology of infertility

2017 ◽  
Vol 6 (12) ◽  
pp. 5322
Author(s):  
Hema K. R. ◽  
Lalitha H. S.
Keyword(s):  
Diagnostic Laparoscopy ◽  
Secondary Infertility ◽  
Peritoneal Disease ◽  
College Hospital ◽  
Medical College ◽  
Uterine Anomalies ◽  
Morphological Defects ◽  
Indispensable Tool ◽  
Infertility Patients

Background: Although population explosion is a major problem in India, infertility appears to be a problem in 5-15% of Indian population. All these patients require evaluation. Laparoscopy plays a valuable role in the diagnosis of infertility. After thorough clinical examination and specific investigations, diagnostic laparoscopy is performed to detect patency of tubes, morphological defects in uterus, ovaries and tuboperitoineal factors. This study was conducted to assess the role of diagnostic laparoscopy in the investigation of female infertility and to evaluate the various causes of infertility like endometriosis, PCOD tubal and peritoneal factors, uterine anomalies, tuberculosis etc. by using diagnostic laparoscopy.Methods: Study was carried out in 60 infertile patients attending outpatient department of hospitals attached to Sri Siddhartha Medical College Hospital, Tumkur.  Both primary and secondary infertility patients who were anxious to conceive and undergo diagnostic laparoscopy were evaluated. Those who were not willing and who were contraindicated for the procedure were excluded.Results: Diagnostic laparoscopy was performed in 72% of primary and 28% of secondary infertility patients. Majority of the patients of primary infertility were in age group 21-25 years and that of secondary were between 26-30 years. Majority of patients in both the groups had duration of 1-5 year of infertility. In our study tubal factors (50%) contributed to majority of the infertility causes. Complication rate was minimum and was comparable to other standard studies.Conclusions: Laparoscopic is the gold standard for diagnosing tubal and peritoneal disease, endometriosis and other pelvic pathology, because no other imaging technique gives the same degree of sensitivity or specificity. Hence diagnostic laparoscopy is an indispensable tool in the evaluation in the evaluation infertility.

scholarly journals Evaluation of tubal patency by sonosalpingography is as good as hysterosalpingography in infertile women

2017 ◽  
Vol 6 (11) ◽  
pp. 5129
Author(s):  
C. Santhana Lakshmi ◽  
Kumara Sampath ◽  
Parvatha Vardani
Keyword(s):  
Sensitivity And Specificity ◽  
Predictive Value ◽  
High Sensitivity ◽  
Tubal Patency ◽  
Less Invasive ◽  
Significant Difference ◽  
Invasive Method ◽  
Tubal Factor ◽  
Primary Health Care Centers ◽  
Health Care Centers

Background: Tubal pathology is one of the causes of infertility in sub fertile couples. Therefore, evaluation of fallopian tubes forms an essential part of evaluation in a sub fertile woman. The aim of the study was to compare the efficacy of sonosalpingography which is a less invasive method when compared to hysterosalpingogram for evaluation of utero-tubal factor in females.Methods: A total of 95 patients 69 with primary infertility and 26 with secondary infertility attending our Obstetrics and Gynecology department were recruited for the study from June 2016 to July 2017. All the study subjects underwent Sonosalpingography on day 5th to 7th and Hysterosalpingography on 7th to 9th day of the menstrual cycle. Data was collected and compared to assess the sensitivity and specificity of sonosalpingography over hysterosalpingography. Statistical analysis was done by using SPSS software version 16.0.Results: Sonosalpingography (SSG) has 97% sensitivity and 94% specificity in comparison to hysterosalpingography (HSG). Analysis of the raw data gave positive predictive value of 98.3% and negative predictive value of 75%. From the results of this study it clear that there is no statistically significant difference (p = 0.237) between the results of the two methods (SSG and HSG).Conclusions: As sonosalpingogrpahy has high sensitivity and specificity and is less invasive. It should be used initially to assess tubal patency in cases of infertility. SSG is found to be a reliable, relatively less expensive diagnostic and therapeutic procedure in the management of infertility in females. Easy availability and accessibility of ultrasound in all primary health care centers definitely can prove superior to conventional method of diagnosis of tubal patency in such patient.

scholarly journals Laparoscopy as a diagnostic tool in evaluation of female factors in infertility

2017 ◽  
Vol 6 (3) ◽  
pp. 864 ◽  
Author(s):  
Chaitra Krishna ◽  
Prathima S. ◽  
Savitha Chandraiah ◽  
Anitha G. S.
Keyword(s):  
Diagnostic Laparoscopy ◽  
Polycystic Ovary ◽  
Well Being ◽  
Common Finding ◽  
Infertile Couple ◽  
Polycystic Ovaries ◽  
Male Factor ◽  
Secondary Infertility ◽  
Infertile Women ◽  
Primary Infertility

Background: Infertility leads to considerable personal suffering and disruption of family life. According to United Nations "Reproductive health is a state of complete physical mental and social well-being and not merely the absence of disease or infirmity in all matters relating to the reproductive system and to its functions and processes". The objective of present study was to find out different causes of female infertility with diagnostic laparoscopy and their comparative frequency in primary and secondary infertility.Methods: It is a prospective study conducted on all infertile women and they underwent diagnostic laparoscopy for primary and secondary infertility during the study period. Couples who had not lived together for at least 12 months, and those with male factor infertility were excluded. Data were collected on a proforma, and analyzed on SPSS package for windows version 10. Frequencies were calculated for laparoscopic findings regarding primary and secondary infertility.Results: Fifty infertile women underwent laparoscopy during the study period, 35 (70%) had primary infertility while 15 (30%) secondary infertility. 10 (28.5%) patients with primary and 3 (20%) patients with secondary infertility had no visible abnormality. The common finding was tubal blockage in 10 (28.5%) and 5 (33.3%) cases of primary and secondary infertility respectively. 9 (25.7%) cases of primary infertility were detected as polycystic ovaries (PCO) and 2 (13.3%) in cases of secondary infertility. Endometriosis was found in 1 case with primary infertility and 2 (13.3%) cases with secondary infertility. Fibroid was found in 3 (8.57%) and 1 (6.6%) cases of primary and secondary infertility respectively.Conclusions: Most common causes responsible for infertility were tubal occlusion and polycystic ovary. Infertile couple should be thoroughly investigated. Laparoscopy in infertility can be used for a definitive diagnosis.

STUDY OF LAPAROSCOPIC EVALUATION OF FEMALE FACTORS IN INFERTILITY AT ANMMCH, GAYA, BIHAR

2021 ◽  
pp. 60-62
Author(s):  
Pankaj Kumar Chaudhary ◽  
Anupam Chaurasia ◽  
Lata Shukla Dwivedy ◽  
Debarshi Jana
Keyword(s):  
Diagnostic Laparoscopy ◽  
Polycystic Ovaries ◽  
Male Factor ◽  
Secondary Infertility ◽  
Infertile Women ◽  
Medical College ◽  
Primary Infertility ◽  
Common Causes ◽  
Tubal Blockage ◽  
Laparoscopic Evaluation

Objective:To nd out different causes of female infertility with diagnostic laparoscopy and their comparative frequency in primary and secondary infertility. Study Design:Acase series. Place and Duration of Study: Department of Obstetrics and Gynaecology, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, August 2018 to July 2019. Methodology:All infertile women underwent diagnostic laparoscopy for primary and secondary infertility during the study period were included. Couples who had not lived together for at least 12 months, and those with male factor infertility were excluded. Data were collected on a proforma, and analysed on SPSS package for windows version 10. Frequencies were calculated for laparoscopic ndings regarding primary and secondary infertility. Results: Fifty infertile women underwent laparoscopy during the study period, 32 (64%) had primary infertility while 18 (36%) secondary infertility. Eight (25.0%) patients with primary and 2 (11.1%) patients with secondary infertility had no visible abnormality. The common nding was tubal blockage in 7 (21.9%) and 6 (33.3%) cases of primary and secondary infertility respectively. Five (15.6%) cases of primary infertility were detected as polycystic ovaries (PCO) which was not found in cases of secondary infertility. Endometriosis was found in 4 (12.5%) cases with primary infertility and 2 (11.1%) cases with secondary infertility. Pelvic inammatory disease (PID) was found in 1 (3.1%) and 2 (16.7%) cases of primary and secondary infertility respectively. Peritubal and periovarian adhesions were detected in 2 (6.3%) cases with primary infertility and 4 (22.2%) cases with secondary infertility. Fibriod was found in 2 (6.3%) and 1 (5.6%) cases of primary and secondary infertility respectively. Ovarian cyst detected in 2 (6.3%) cases with primary infertility while none was found in cases of secondary infertility. Conclusion: Most common causes responsible for infertility were tubal occlusion, endometriosis, peritubal and periovarian adhesions. Ovarian causes were seen in primary infertility only

Hysteroscopic Management of Intrauterine Pathologies: A Case Series of 296 Patients

2017 ◽  
Vol 5 (1) ◽  
pp. 35-40
Author(s):  
Rahul Manchanda ◽  
Charu Pathak ◽  
Garima Yadav
Keyword(s):  
Case Series ◽  
Uterine Cavity ◽  
Postmenopausal Bleeding ◽  
Secondary Infertility ◽  
Diagnostic Modality ◽  
Endometrial Polyps ◽  
Detection Rates ◽  
Primary Infertility ◽  
Endocervical Canal ◽  
Infertility Patients

ABSTRACT Aims To discuss the incidence of various hysteroscopic findings in patients of infertility, abnormal uterine bleeding (AUB), and postmenopausal bleeding and to compare the prevalence of various uterine pathologies in patients of primary and secondary infertility. Materials and methods This is a retrospective observational study, which evaluated 296 patients who underwent diagnostic hysteroscopy for evaluation of primary or secondary infertility, AUB, and postmenopausal bleeding over a period of 18 months in a Gynae-endoscopy Unit. Detailed hysteroscopic evaluation of the endocervical canal and uterine cavity in all recruited cases was done by the same surgeon and the data were collected by reviewing the case records. Results Among the 296 cases analyzed, 157 cases were of primary infertility, 81 cases were of secondary infertility, 45 cases were of AUB, and 13 cases presented with postmenopausal bleeding. Among the primary infertility patients, 58.6% had abnormal findings on hysteroscopy, while among the secondary infertility patients, hysteroscopy revealed abnormalities in as high as 72.5% cases. In the present study, uterine synechiae was the most common abnormality detected among the infertile patients. Endometrial polyps were the most common pathology detected among patients with AUB and postmenopausal bleeding. Conclusion Hysteroscopy is a minimally invasive and highly safe technique to directly visualize the endocervical canal, uterine cavity, and tubal ostia. It has an added advantage of treating the pathology in the same sitting, thus improving the clinical outcomes. Based on our findings, we conclude that uterine pathologies are a major contributor in causing infertility and menstrual irregularities, which are missed on blind modalities like hysterosalpingography and dilatation and curettage. Clinical significance This article stresses on the use of hysteroscopy as a primary diagnostic modality in evaluating patients of infertility, AUB, and postmenopausal bleeding in order to increase the detection rates of uterine pathologies. How to cite this article Yadav G, Manchanda R, Pathak C. Hysteroscopic Management of Intrauterine Pathologies: A Case Series of 296 Patients. J South Asian Feder Menopause Soc 2017;5(1):35-40.

scholarly journals Evaluation of cases of infertility by diagnostic laparoscopy

2017 ◽  
Vol 6 (3) ◽  
pp. 924
Author(s):  
Sachin Wankhede ◽  
Sarika Thakare ◽  
Nivedita Goverdhan ◽  
Santosh Shahane
Keyword(s):  
Diagnostic Laparoscopy ◽  
Male Factor Infertility ◽  
Polycystic Ovaries ◽  
Male Factor ◽  
Secondary Infertility ◽  
Primary Infertility ◽  
Therapeutic Benefits ◽  
Obstetrics And Gynaecology ◽  
Uterine Anomalies ◽  
Tubal Disease

Background: Infertility affects nearly 10-15% of couples and is an important part of clinical practice. Leading causes of infertility include tubal disease, ovulatory disorders, uterine or cervical factors, endometriosis and male factor infertility. The objective of the study was to find out different causes of female infertility with diagnostic laparoscopy.Methods: This was a descriptive study conducted from February 2012 to November 2013. 115 patients with infertility attending the infertility clinic in OPD of Obstetrics and Gynaecology were evaluated clinically with detailed history. The necessary investigations were carried out and the laparoscopic findings were documented.Results: There were 91 cases (79.13%) with primary infertility and 24 (20.87%) with secondary infertility. Laparoscopy revealed normal findings in 14 cases (15.38%) of primary infertility and 1 case (4.17%) of secondary infertility. Pelvic abnormality was found in 100 cases (86.95%). Tubal block was the most common pathology found in 36 cases (31.30%) followed by polycystic ovaries in 32 (27.83%) and adhesions in 24 (20.87%). Uterine anomalies were found in 3 cases (3.30%).Conclusions: Diagnostic laparoscopy is a valuable technique and a mandatory investigation, which, though invasive, is more convenient and more precise for the diagnosis of infertility. Because of its potential diagnostic as well as therapeutic benefits, all patients with infertility should undergo diagnostic laparoscopy as part of their primary workup of infertility.

scholarly journals Is hysterolaparoscopy a real theranostic approach for anatomical barriers in female fertility? A future argument

2018 ◽  
Vol 7 (6) ◽  
pp. 2423
Author(s):  
Namita Agrawal ◽  
Poonam Yadav ◽  
S. Fayyaz ◽  
Brinderjeet Kaur
Keyword(s):  
Real Time ◽  
Female Fertility ◽  
Therapeutic Interventions ◽  
Secondary Infertility ◽  
Female Patients ◽  
Primary Infertility ◽  
Diagnostic Work ◽  
Infertility Patients ◽  
Work Up ◽  
Diagnostic Work Up

Background: Hysterolaparoscopy is a modality that provides the real time abdomino-pelvic view during diagnosis in infertile female patients and any pathology is noticed can be tackled at the same time. So we investigate the theranostic application of hysterolaparoscopy in structural causes of female infertility in present study.Methods: Authors prospectively evaluate 157 female patients (mean age 27.7 years) diagnosed as infertile, underwent hysterolaparoscopy during diagnostic work-up.  All the enlisted patients fulfilled the criteria of infertility. The noticed anatomical abnormalities in the hysterolaparoscopy were tackled at the same time if possible.Results: Of the 157 infertile female patients, 93 (~59.2%) were of primary infertility and remaining 64 (~41.8%) were secondary infertility patients. Hysterolaparoscopy showed abnormalities in 125/157 (~85.0%) patients. The detected hysterolaparoscopic abnormalities were distributed in 77/93 (~82.8%) primary and 48/64 (~75.0%) secondary infertility patients. Of the 125 patients with abnormal hysterolaparoscopic findings, 121 (~96.8%) experienced for active therapeutic interventions. All of the 48 secondary infertility patients with hysterolaparoscopic abnormalities experienced for active hysterolaparoscopic interventions. Of 77 patients with hysterolaparoscopic abnormality in primary infertility group, 73 (~94.8%) experienced active intervention. Only four patients with streak ovaries and hypoplastic uterus, few tiny fibroids and adenomyosis did not undergo for active hysterolaparoscopic intervention.Conclusions: Authors concluded that hysterolaparoscopy has a better theranostic approach for the anatomical barriers of female fertility so it can be performed in the initial phases of the infertility diagnostic work-up.

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