Evaluation of endoscopic procedures in terms of achieving pregnancy in female infertile patients: An experience at a single tertiary care center

Objectives. - To evaluate the success rate of endoscopic procedures in terms of achieving pregnancy at an interval of three months for 12 months or till achievement of fetal cardiac activity whichever is earlier. Methods. - We prospectively evaluated 157 female patients (age range 19-35 years; mean age 27.75 years), who were diagnosed as infertile. During their diagnostic work, all underwent hysterolaparoscopy. The detected anatomical abnormalities on the hysterolaparoscopy were tackled at the same time during diagnostic work-up if possible. After hysterolaparoscopy, Patients were advised for regular sexual activity. The follow-up of all recruited patients was done at an interval of three months for 12 months or till achievement of fetal cardiac activity. Results. - Of the 157 infertile female patients, 93 (59.2%) were of primary infertility and remaining 64 (41.74%) were secondary infertility patients. Hysterolaparoscopy revealed abnormalities in 125/157 patients. The detected hysterolaparoscopic anatomical abnormalities were distributed in 77/93 (82.8%) primary and 48/64 (75%) secondary infertility patients. Of the 125 patients with abnormal hysterolaproscopic findings. 121 underwent active therapeutic interventions. All of the secondary infertility patients with hysterolaparoscopic abnormalities experienced active hysterolaparoscopic interventions. Of 77 patients with hysterolaparoscopic abnormality in primary infertility group. 73 patients experienced active intervention. Out of the 125 abnormal hysterolaparoscopic patients, 121 underwent active intervention and 43 patients conceived during next 12 months. Among 32 patients with normal hysterolaparoscopic findings, 7 conceived within 12 months. Significantly higher conception was observed in hysterolaparoscopic intervention patients as compared to normal hysterolaparoscopy patients (p similar to 0.001). Independently in primary infertility patients, the conception rate in the patient with hysterolaparoscopic intervention was significantly higher than nonintervention group (p < 0.0001). Similarly, conception rate was significantly higher in secondary infertility patients (p similar to 0.004). Conclusion. - We concluded that the conception rate was significantly high in infertility patients, who underwent hysterolaproscopic intervention. In short hysterolaparoscopy should be considered as a potential gold standard approach in the evaluation of female infertility. (C) 2018 Published by Elsevier Masson SAS.