Sajida Parveen, Majidah Khanam.
Role of combined diagnostic laparoscopy and simultaneous diagnostic hysteroscopy for evaluation of female subfertility factors.
J Surg Pak Jan ;15(1):44-7.

Objective: To find out the role of combined diagnostic laparoscopy and simultaneous diagnostic hysteroscopy in evaluation of female infertility. Study design: Descriptive study. Place & Duration of study Star General Hospital from January 2009 to December 2009. Methodology: Patients were selected from infertility clinic for female factor evaluation by diagnostic laparoscopy and simultaneous diagnostic hysteroscopy. Dye studies as well as observation of pelvic and intrauterine cavity was done under general anaesthesia during laparoscopy and hysteroscopy. Results: A total of 62 women underwent combined diagnostic laparoscopy and simultaneous diagnostic hysteroscopy. Age ranged from 25 years to 38 years and a mean age was 28.4 years. Bilateral tubal patency was demonstrated in 40 (64.5%) patients. Bilateral tubal blockage found in 10 (16.12%) and unilateral tubal occlusion was present in 12 (19.3%) cases. Myomas were found in 4 (6.45%), three found on laparoscopy and one at hysteroscopy. Endometrial polyps were revealed in 6 (9.6%) and Asherman syndrome in 2(3.2%) patients on diagnostic hysteroscopy. Uterine anomalies were found in 8 (12.9%) patients including arcuate uterus in 4 (6.45%), septate in 2 (3.2%), bicornuate and uterine didelphys in one each. Of total, 5 (8.0%) were found to have endometriosis, 12 (19.35%) had polycystic disease of ovary (PCOD), and 3 (4.8%) had functional cyst of ovary. Pelvic adhesions were found in 7 (11.2%) patients. As a whole pelvic pathologies were confirmed in 52 (83.8%) patients and intrauterine pathology in 17 (27.4%) by simultaneous diagnostic hysteroscopy and laparoscopy. Conclusion In investigating the causes of female infertility a combined diagnostic laparoscopy and hysteroscopy provides best approach to diagnose the pathologies.

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