Hysterolaparoscopy In Infertility - What Should You Know!

Infertility is a emerging health concern today. According to the Indian Society of Assisted Reproduction, around 10-15% of Indian women are affected by infertility. The rate goes up in urban areas where every one in six women is diagnosed infertile. Around 27 million couples in India require assistance to reproduce.

What is hysterolaparoscopy?

This is an endoscopic procedure, where small telescope is introduced in abdominal cavity. Reproductive organs like uterus, ovaries, fallopian tubes, pouch of douglas are examined under magnified view. It can be diagnostic or operative scopy in case of any pathologies. Tubal patency can be confirmed using methylene blue dye (diluted one).

Just one session can clear questions relating to tubal patency, ovarian morphology, uterine abnormalities and undetected pelvic pathology. Moreover, other procedures like hysteroscopy guided tubal cannulation, lateral or fundal metroplasty, biopsy, polypectomy, adhesiolysis, septal resection and myomectomy can all be performed in the same sitting.

Which infertility patients benefit from Hystero laparoscopy?

Common indications-

• Fibroids

• Endometriosis

• Unilateral or bilateral tubal block

• Hydrosalpinx/ pyosalpinx

• Pelvic inflammatory diseases

• Septate uterus

• Asherman's syndrome

• T shaped cavity

Hysterolaparoscopy is an efficient way to optimize fertility. It is usually done when simple treatment modalities fails to achieve pregnancy or when SSG (Sono salpingo graphy)/HSG(hystero salpingo graphy) suggests tubal block or for other associated pathologies listed above or in cases of unexplained infertility.

Hysteroscopy deals with pathologies in uterine cavity, so plays vital role for women going for IVF, especially those with recurrent miscarriages, thin endometrium, h/o recurrent implantation failures, submucous myomas. Cases with Asherman's Syndrome or big submucous myomas may need second look hysteroscopy. This is a daycare procedure, whereas Laparoscopy needs at least 24 hour hospital stay. The procedure requires advanced equipments & skilled surgeon. It offers speedy recovery and minimum number of stitches on the abdomen. All this has made hysterolaparoscopy, an important tool in the evaluation of infertility.