A study of role of hysteroscopy in infertility

Introduction: Infertility is a bane of modern living. It inflicts devastating emotional trauma on the individual for being unable to fulfill the biological role of parenthood. In India, 10-15% of the couples are infertile. There is an increased demand for diagnostic and therapeutic intervention for management as infertility is a social stigma. This study is aimed to assess the role of hysteroscopy in workup of female infertility and analyze if this is the primary method in evaluation of infertility after hormonal profile and semen analysis. Materials and methods: A retrospective analysis of 100 infertile patients was carried out for a period of 1 year at Santati IVF centre, Thane. Various factors such as cervical, tubal and endometrial were analyzed as post hysteroscopy findings as the cause of infertility. Results: Hysteroscopy was performed in 100 infertile women, out of which 56(56%) presented with primary infertility and 44(44%) women were with secondary infertility. Normal intrauterine finding were found in 43 women (43%). Abnormal hysteroscopic findings were found in 57 women of which maximum women were primary infertility (39%). Cervical factor abnormalities were found in 17% of women either in form of erosion (9%) or internal Os stenosis (8%). Most common finding in primary infertility group was uterine septum (10%) followed by endometrial polyp, small uterine cavity, intrauterine adhesion, T-shaped cavity and sub septate uterus. However, in one patient finding of anunicornuate uterus was achieved. In secondary infertility group, abnormal Intrauterine Findings Were Detected In 23/44 Women, The Most Common Finding Being Endometrial polyp. In primary infertility group, 10 women had undergone septoplasty and 7 metroplasty, 4 had polypectomy, 3 had adesiolysis and ostia opened for 2. In secondary infertility group, metroplasty was the most common interventional procedure done (9%) followed by polypectomy, septoplasty, adhenolysis and opening of blocked ostia. Conclusion: Hysteroscopy is effective in not only evaluation of infertility but also in correcting the causal factors. In view of above findings of the study, it seems worthwhile to consider hysteroscopy as the first line of investigation for evaluation of female infertility after the initial investigations are within normal limits.