RETROSPECTIVE ANALYSIS OF HYSTEROSCOPY AND HYSTEROSALPINGOGRAPHY: COMBINED PROCEDURE AS A FIRST LINE INFERTILITY WORK UP

Abstract

Background: Hysterosalpingogarphy (HSG) has traditionally been the first line of investigation for evaluating anatomy and contour of uterine cavity along with fallopian tubes and its patency. Because of limitations of HSG, video endoscopic evaluation of endometrial and peritoneal cavity by diagnostic hysteroscopy and laparoscopy can diagnose many subtle and obvious pathologies in cases of infertile couple.

Objective: To study the usefulness of hysteroscopy and HSG as a combined procedure in a single setting to identify uterine pathologies as an infertility work up.

Study design: Retrospective analysis

Study duration: 2012 – 2017 (5years)

Setting: IVF unit, Radhakrishna Multispeciality Hospital & IVF centre, Bangalore.

Study population: 356 infertile women who underwent both hysteroscopy and HSG.

Results: Abnormal intrauterine finding was noted in 161 cases (44.9%). Among patients with abnormal intrauterine findings, hyperplastic endometrium was seen in 35 (9.8%), polypoidal endometrium in 52 (14.6%), uterine septum in 40 (11.2%), intrauterine adhesions in 22(6%) and myoma in 12 (3.3%). Concurrent interventions were performed in almost all of them. Tubal block was noted in 28 cases (7.8%).

Conclusion: Complete evaluation of uterus and tubes can be made by combining hysteroscopy and HSG in the same setting. Other advantages are patient comfort, cost effectiveness, better identification of pathologies and further treatment can yield good conception rates

Keywords: Hysteroscopy; Hysterosalpingography; Infertility