COMBINED DIAGNOSTIC APPROACH OF HSG AND DIAGNOSTIC HYSTEROLAPAROSCOPY IN EVALUATION OF FEMALE INFERTILITY

Background: Since the history of mankind, human infertility has been a source of personal misery and social stigma. The aim of the present study is to assess the combined diagnostic approach of HSG and DHL in the evaluation of female infertility both primary and secondary and to identify the incidence of the various pathological conditions in the female reproductive tract leading to infertility and to study the advantages of diagnostic hysterolaparoscopy over hysterosalpingography. Method: The present study is a prospective observational study, conducted in the department O & G, SCBMCH, Cuttack. One hundred infertile patients were included in this study. All patients underwent both HSG and DHL. The standard protocols for HSG and DHL were followed. All reports on the 100 selected patients were reviewed. Result:In our study, 68% patients are in primary infertility and 32% in secondary infertility. Maximum number of patients with primary infertility were in the age group of 26- 30 years i.e. 50% and 56.3% in secondary infertility. Tubal pathologies were the commonest of all followed by filling defects like myoma, polyps, synechiae and uterine anomalies in both HSG and DHL in both the primary and secondary infertility groups. Surgical interventions were done in 84% of primary infertility cases and in 97% of secondary infertility cases. The therapeutic measures were taken like polypectomy, myomectomy, septum resection during hysteroscopy. Most commonly done procedure in this study was adhesiolysis in 22 ? 24% of cases followed by cannulation in15-22% cases. Conclusion: Our study found that Hysterosalpingography is simple, inexpensive, safe and rapid diagnostic modality for tubal patency then laparoscopy. Laparoscopy is considered the Gold Standard for diagnosing tubal and peritoneal disease. HSG and Laparoscopy are not alternative, but complimentary to each other but hysterolaparoscopy is more informative and operative intervention can be done in the same sitting.