Evaluation of Tubal Factor In Infertility: A Comparative Study by Laparoscopy and Hysterosalpingography

Abstract

Introduction: In women, the causes of infertility include tubal disease, ovulatory dysfunction, endometriosis, immunological factors, congenital abnormalities and sexual dysfunction or it could be unexplained. Tubal infertility is one of the commonest causes of infertility in India. Aims and Objective: To evaluate and compare the tubal and peritoneal factors in infertile women through hysterosalpingography and laparoscopy. Materials and Methods: The present prospective study was conducted in the Department of Obstetrics and Gynaecology, Gauhati Medical College and hospital, Guwahati, Assam. A total of 50 cases of both primary and secondary infertility attending Gynaecology OPD were recruited. Initially HSG was done for all patients followed by laproscopic evaluation. Results: Majority of the patients were of primary infertility, and in age group between 25-29 years. It was observed that sensitivity of the HSG was 100% and specificity was 85%. Laparoscopy is a better diagnostic tool for diagnosis of peritubal adhesion and pelvic pathology. There were 36% cases showing associated pelvic pathology in laparoscopy, while it could be picked up in only 8% patients with hysterosalpingography.Conclusion: Laparoscopy along with HSG is very effective method in evaluating cases of infertility especially tubal blockage. HSG should be done first followed up by laparoscopy. Laparoscopy complements and broadens the diagnostic scope of HSG. Both procedures have their own importance and none can substitute the other in diagnosing tubal factors in infertility.