scholarly journals Role of diagnostic hysterolaparoscopy in the evaluation of female infertility

2019 ◽  
Vol 7 (5) ◽  
pp. 1531
Author(s):  
Madhuri N. ◽  
Rashmi H. S. ◽  
Sujatha M. S. ◽  
Dhanyata G.
Keyword(s):  
Tertiary Care ◽  
Female Infertility ◽  
Reproductive Age ◽  
Common Finding ◽  
Care Hospital ◽  
Male Factor ◽  
Secondary Infertility ◽  
Unprotected Sexual Intercourse ◽  
Primary Infertility

Background: Infertility is defined by WHO as a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. The prevalence of infertility is about 10%-15% of reproductive age couples. Female factor is responsible for 40-45% of etiology of infertility. Aim of the study was to evaluate the role of diagnostic hysterolaparoscopy in female infertility at a tertiary care centre.Methods: This is a retrospective hospital based study done at a tertiary care hospital attached to JSS Medical College, Mysuru between January 2017 and December 2018. Infertile women with primary or secondary infertility in the 18-40 years age group, with normal hormonal profile and no known male factor were included.Results: In our study, primary infertility was found in 77% of the 96 patients and secondary infertility was found in 23% of patients. In primary infertility, ovarian pathology was the most common finding while Endometriosis was the most common finding in secondary infertility group. 77 % patients were found to have bilaterally patent tubes while remaining had unilateral or bilateral blockage. On hysteroscopy, endometrial polyps were the commonest hysteroscopic finding in both groups.Conclusions: Combined hystero-laparoscopy is a safe, effective and reliable method in comprehensive evaluation of infertility. It helps in the diagnosis of pelvic pathology which may have been missed by routine examination and thereby helps in optimal management of female infertility.

scholarly journals Analysis of causes and clinical pattern of infertility in couples coming to a tertiary care centre in Bihar, India

2017 ◽  
Vol 6 (6) ◽  
pp. 2279
Author(s):  
Kalpana Singh ◽  
Rekha Kumari ◽  
Alok Ranjan ◽  
Geetam Bharti
Keyword(s):  
Laboratory Tests ◽  
Semen Analysis ◽  
Tertiary Care ◽  
Reproductive Age ◽  
Tertiary Care Centre ◽  
Male Factor ◽  
Secondary Infertility ◽  
Unprotected Sexual Intercourse ◽  
Clinical Pattern ◽  
High Level

Background: Infertility is one of the major health problems and a socially destabilizing condition for couples often causing marital disharmony. Infertility is defined as the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. Worldwide, its prevalence is approximately 8-12%.There are numerous factors such as anatomical, physiological and genetic factors that cause infertility. Many environmental and acquired factors also lead to inability to conceive. Objective of the present study was to determine the causes and clinical pattern of infertility in infertile couples.Methods: It was a hospital based observational study carried out on 750 women in reproductive age group attending out-patient clinic of Reproductive Biology Department of Indira Gandhi Institute of Medical Sciences (IGIMS) at Patna during April 2013 to March 2017. All the cases of primary and secondary infertility diagnosed after full examinations and laboratory tests were included and cases lacking of full examinations and laboratory tests were excluded. All the data of infertile couples were recorded in a semi-structured Case Information Performa.Results: Out of 750 women 454 women had all the data and they participated in the study Nearly 68% women had primary infertility and rest had secondary infertility. Male factor was responsible in 37.39%, female factor in 20.48%, unexplained in 22.46% while a combination of both factor was seen in 8.37% cases in our study .135 women had irregular menstrual cycles in which 64(47%) had oligomenohhrea. 79% women had normal ultrasonography and nearly 11% of women had evidence of PCOD. 24% women had hypothyroidism (TSH more than 4.5 IU/L) and 59(13%) were found to have high level of prolactin i.e. >25 ng/ml. Nearly 8% of women had high level of FSH i.e. more than 10 IU/L which is an indicator of ovarian resistance. In nearly 16% women one fallopian tube was found blocked and 8% had both tubes blocked in hysterosalpingography. Husband semen analysis was done to assess male factor. Nearly 14% of their male partners suffered from azoospermia and 23% had at least one abnormal parameter in semen analysis.Conclusions: Etiological pattern of infertility varies in different parts of World. Male and female factors both are responsible for infertility. So, both the partners should be counselled and investigated properly.

scholarly journals Role of hysterolaparoscopy in the evaluation of female infertility in a tertiary care centre

2019 ◽  
Vol 8 (12) ◽  
pp. 4955
Author(s):  
Bharti Choudhary Parihar ◽  
S. Gowri
Keyword(s):  
Social Stigma ◽  
Tertiary Care ◽  
Female Infertility ◽  
Tertiary Care Centre ◽  
Secondary Infertility ◽  
Primary Infertility ◽  
Tubal Blockage ◽  
Gandhi Medical College ◽  
Infertile Patients

Background: Infertility is one of the most important and underappreciated reproductive health problems in developing countries. Inability to conceive bears a social stigma which causes societal repercussion and personal suffering. The advent of hysterolaparoscopy have redefined the evaluation and treatment of infertile women. Study aimed to assess the role of hysterolaparoscopy in the evaluation of female infertility.Methods: This prospective observational study was done in the department of obstetrics and gynaecology, Gandhi Medical College, Sultania Zanana Hospital, Bhopal, during the period between 1st December 2016 to 30th November 2017. 104 infertile patients either with primary or secondary infertility were included after thorough evaluation.Results: Out of 104 infertile patients, 82(78.8%) women had primary infertility and rest 22(21.1%) women had secondary infertility. In primary infertility group, most common laparoscopic finding was PCOD in 24(29%) women and in secondary infertility group, tubal blockage was seen in 9(40%) women. The most common pathology seen in hysteroscopy was submucous fibroid in 6(7.3%) women with primary infertility, whereas in secondary infertility group, synechiae was found in 2(9%) patients and septum was seen in 1(4.5%) patient. Out of 104 patients, 33 (31.7%) patients underwent various interventions. The most common intervention was ovarian drilling for PCOS in 21(63.3%) patients followed by hysteroscopic cannulation in 5(15.5%) patients.Conclusions: Hysterolaparoscopy is a very useful tool that can detect various structural abnormalities in multiple sites like uterus, tubes, ovaries and peritoneal cavity in the same sitting. When done by experienced hands and proper selection of patients, hysterolaparoscopy can be considered as a definitive investigative procedure for evaluation of female infertility.

scholarly journals Prospective evaluation of causes of infertility at a tertiary care hospital

2018 ◽  
Vol 6 (12) ◽  
pp. 3988
Author(s):  
Monica Soni ◽  
Santosh Kumari
Keyword(s):  
Semen Analysis ◽  
Demographic Data ◽  
Tertiary Care ◽  
Reproductive Age ◽  
Care Hospital ◽  
Male Factor ◽  
Unprotected Sexual Intercourse ◽  
North West ◽  
Infertile Women ◽  
Infertile Couples

Background: Infertility is defined as the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. Worldwide, its prevalence is approximately 8-12%. There are numerous factors such as anatomical, physiological, genetic, environmental and acquired factors that cause infertility. The aim of the present study was to determine the causes and clinical pattern of infertility in infertile couples in North West India.Methods: It was a hospital based observational study carried out on 211 infertile couples in reproductive age group attending infertility clinic of Sardar Patel Medical College and associated PBM Hospital, Bikaner, Rajasthan between September 2016-February 2017. Collection of data was performed by means of a specifically designed questionnaire, which apart from the demographic data also included questions concerning the causes of infertility. Cases of infertility diagnosed after detailed history, clinical examinations and laboratory tests were included.Results: Out of 211 infertile couples, female factor was predominant in 60.18%, male factor in 15.16%, unexplained in 15.16% while a combination of both factors was seen in 9.47% cases in our study. 33.17% women had ovulatory dysfunction diagnosed by menstrual history and ultrasonography. Tubal block was observed in 9.47% infertile women. 6.63% women had hypothyroidism and 1.89% infertile women were diagnosed to have endometriosis. Husband semen analysis was also done to assess male factor. Nearly 5.21% of their male partners suffered from oligospermia, 4.73% had azoospermia and oligoasthenospermia was observed in 3.79% male partners.Conclusions: Predominant cause of infertility can be reported in male or female partner or both so, either partner should be counselled and investigated properly. Our study reports a predominance of female factors as a cause of female infertility but male factors also accounted for a significant number of cases.

scholarly journals A prospective study on the role of Hysterolaparoscopy in the evaluation of infertility

2019 ◽  
Vol 8 (12) ◽  
pp. 4766
Author(s):  
Pandeeswari B. ◽  
Shalini Mahana Valecha
Keyword(s):  
Age Groups ◽  
Female Infertility ◽  
Reproductive Age ◽  
Current Evidence ◽  
Secondary Infertility ◽  
Ovulatory Period ◽  
A Prospective Study ◽  
Work Up ◽  
Ovarian Syndrome

Background: Infertility affects about 10-15% of couples of reproductive age groups. The current evidence indicates a 9% prevalence of infertility with 56% of couples seeking medical care. Hysterolaparoscopy provides a comprehensive investigative procedure in which various factors causing female infertility can be assessed at one sitting.Methods: A total 100 infertile women between 20-40 years of age including primary and secondary infertility were evaluated. Patients would be investigated thoroughly for infertility and in preparation for anaesthesia. Tests include follicular study, Ultrasound pelvis. Hysterolaparoscopy was performed in the pre ovulatory period between days 6-10 of the cycle for infertility evaluation.Results: In the present study out of 100 cases for infertility evaluated, primary infertility were 57(57%) and secondary infertility were 43(43%). In our study out of 100 patients, Hysterolaparoscopy showed tuberculosis in 24 (24%) patients, remaining were endometriosis, polycystic ovarian syndrome, congestion, intra-pelvic adhesions, hydro-salpinx.Conclusions: It is concluded that while treating the causes of female infertility combined simultaneous diagnostic laparoscopy and hysteroscopy should be performed in all infertile patients as” seeing is believing” and if any pathologies found to be operable the gynaecologist can perform operative hystero-laparoscopy at that time, hence anticipating the pathologies after pre-operative work up is very important.

scholarly journals A community based study to determine the prevalence of infertility and associated socio demographic factors in rural area of Mandya district of Karnataka

2019 ◽  
Vol 6 (6) ◽  
pp. 2444
Author(s):  
Shashank Kumbarahalli Javaregowda ◽  
Praveen Govindagowda ◽  
Chethan Thotahalli Krishna ◽  
Supriya Varadaraju
Keyword(s):  
Rural Area ◽  
Demographic Factors ◽  
Unprotected Sex ◽  
Reproductive Age ◽  
World Health ◽  
Age Group ◽  
Secondary Infertility ◽  
Unprotected Sexual Intercourse ◽  
Primary Infertility ◽  
Socio Demographic Factors

Background: Infertility is defined as failure to achieve pregnancy after at least 1 year of regular unprotected sexual intercourse. Infertility is classified into two types, primary and secondary infertility. World Health Organization explains primary infertility as inefficiency to conceive after a year of unprotected sex and secondary if not conceived following previous pregnancy. The objective of the study was to find out the prevalence and socio demographic factors of infertility (primary and secondary) among eligible couples in rural area of Mandya district.Methods: A Cross sectional study was conducted at Adichunchanagiri Institute of Medical sciences from the month of June 2016 to September 2016.One of the Primary health center in the study area was randomly selected by lottery method. All the eligible couples who are permanent residents and in the reproductive age group were included in the study.Results: Majority (59.64%) of the study group were in the age group of 20-25 years. Nearly 59.3% and 40.7% of the respondents belonged to joint and nuclear family respectively. The overall prevalence of infertility in our study was 7.7%. The overall prevalence of primary infertility was 6.3% and secondary infertility was 1.4%.Conclusions: As healthcare professionals, we should remember that infertility is a stressful life event for both women and men. Hence by knowing the prevalence and knowledge of the couple regarding the infertility, suitable health education programmes can be done to create awareness among the people regarding the treatment modalities available for infertility. 

scholarly journals Laparoscopy as a diagnostic tool in evaluation of female factors in infertility

2017 ◽  
Vol 6 (3) ◽  
pp. 864 ◽  
Author(s):  
Chaitra Krishna ◽  
Prathima S. ◽  
Savitha Chandraiah ◽  
Anitha G. S.
Keyword(s):  
Diagnostic Laparoscopy ◽  
Polycystic Ovary ◽  
Well Being ◽  
Common Finding ◽  
Infertile Couple ◽  
Polycystic Ovaries ◽  
Male Factor ◽  
Secondary Infertility ◽  
Infertile Women ◽  
Primary Infertility

Background: Infertility leads to considerable personal suffering and disruption of family life. According to United Nations "Reproductive health is a state of complete physical mental and social well-being and not merely the absence of disease or infirmity in all matters relating to the reproductive system and to its functions and processes". The objective of present study was to find out different causes of female infertility with diagnostic laparoscopy and their comparative frequency in primary and secondary infertility.Methods: It is a prospective study conducted on all infertile women and they underwent diagnostic laparoscopy for primary and secondary infertility during the study period. Couples who had not lived together for at least 12 months, and those with male factor infertility were excluded. Data were collected on a proforma, and analyzed on SPSS package for windows version 10. Frequencies were calculated for laparoscopic findings regarding primary and secondary infertility.Results: Fifty infertile women underwent laparoscopy during the study period, 35 (70%) had primary infertility while 15 (30%) secondary infertility. 10 (28.5%) patients with primary and 3 (20%) patients with secondary infertility had no visible abnormality. The common finding was tubal blockage in 10 (28.5%) and 5 (33.3%) cases of primary and secondary infertility respectively. 9 (25.7%) cases of primary infertility were detected as polycystic ovaries (PCO) and 2 (13.3%) in cases of secondary infertility. Endometriosis was found in 1 case with primary infertility and 2 (13.3%) cases with secondary infertility. Fibroid was found in 3 (8.57%) and 1 (6.6%) cases of primary and secondary infertility respectively.Conclusions: Most common causes responsible for infertility were tubal occlusion and polycystic ovary. Infertile couple should be thoroughly investigated. Laparoscopy in infertility can be used for a definitive diagnosis.

scholarly journals Depressive morbidity among female partner of infertile couple in a tertiary care setup in Bangladesh

2019 ◽  
Vol 45 (2) ◽  
pp. 93-98
Author(s):  
Tanzeem S Chowdury ◽  
T A Chowdhury ◽  
Shirin Akter Begum ◽  
Yasmin Begum ◽  
Mehriban Amatullah
Keyword(s):  
Assisted Reproductive Technologies ◽  
Tertiary Care ◽  
Severe Depression ◽  
Reproductive Technologies ◽  
Reproductive Age ◽  
Unprotected Sexual Intercourse ◽  
Female Partners ◽  
Primary Infertility ◽  
Infertile Couples ◽  
Anxiety Depression

Background: There are 80 million infertile couples in the world which correspond to approximately 15% of all couples in their reproductive age. Negative attitude and behavior of family and acquaintances causes severe psychological stress resulting in social discrimination and stigmatization which may lead to anxiety, depression and even suicide. The study was aimed to estimate the prevalence and predictors of depressive morbidity among Bangladeshi infertile women. Methods: This prospective, observational study was done on a total of 215 female partners of infertile couples who attended ‘Infertility Management Center’; a Dhaka based tertiary care setup for infertility management and assisted reproductive technologies from August - December 2016. Only those who were unable to conceive after one year of unprotected sexual intercourse and agreed to take part in the study were included in the study. Patients with history of mental illness prior to infertility diagnosis and on any anti-psychotic drugs were excluded from the study. Data collection was done using the validated Beck Depression Inventory (BDI) questionnaire. Results: Among the study population 72.6% were suffering from primary infertility and 27.4% from secondary infertility. Of them, 52.6% had 5 to 10 years and 47.4% had various duration of infertility. Female cause of infertility was in 30.7% couples, male cause was in 16.3%, both were in 4.7% and finally unknown was 48.4%. Female partners of infertile couples showed different types of mode disorders such as 29.3% (n=63) having severe depression, 39.5% moderate, 20.5% mild and 10.7% having no depression. Association between educational status and depression score showed 53.02% graduate having severe depression, though statistically it was not significant. Depression was most common among patients suffering from primary infertility and among housewives as they probably had more time to think and feel the situation. Conclusion: The high level of depression among female partners of infertile couples revealed in this study is quiet alarming and requires attention of the medical fraternity. This study proposes that clinicians should be more aware about anxiety-depression disorders among infertile groups and the necessity of identifying patients who require psychological assistance. Bangladesh Med Res Counc Bull 2019; 45: 93-96

scholarly journals Role of diagnostic hystero-laparoscopy in the evaluation of female infertility

2019 ◽  
Vol 8 (8) ◽  
pp. 3156
Author(s):  
Deepa Shanmugham ◽  
Nambala Divya Sahitya ◽  
Sindhu Natarajan ◽  
Deepak Kannan Saravanany
Keyword(s):  
Tertiary Care ◽  
Reproductive Age ◽  
Polycystic Ovaries ◽  
Tertiary Care Centre ◽  
Male Factor ◽  
Acute Pelvic Inflammatory Disease ◽  
Tubal Factor ◽  
The Mean ◽  
A Prospective Study

Background: Infertility affects about 10-15% of reproductive age couples. The main causes of infertility include male factor, ovulatory disorders, tubal factor and endometriosis. This study was conducted to determine the role of Diagnostic hystero-laparoscopy (DHL) in the evaluation of female infertility.Methods: This study was a prospective study done in a tertiary care centre over a period of 1 year on all infertile couples. The exclusion criteria: male factor infertility, hypothyroidism, hyperprolactinemia, acute pelvic inflammatory disease. Diagnostic hysterolaparoscopy was performed in all study patients in pre ovulatory phase, under general anaesthesia. The findings were then documented and analysed.Results: A total number of 90 patients were recruited for the study. The mean age of the patients was 28±3 years. The mean BMI of the study patients was 25±4 kg/m2. The mean duration of infertility was 5.4 years. On laparoscopy, 28 patients had polycystic ovaries (31.1%), 4 patients had pelvic adhesions (4.4%), 2 patients had endometriosis (2.2%) and tubal block was identified in 10 patients (11.11%). 10 patients had abnormal findings on hysteroscopy.Conclusions: Hystero laparoscopy is an effective diagnostic tool in the evaluation of infertility and has to be included in basic diagnostic workup.

ANALYTICAL STUDY OF CAUSES OF INFERTILITY IN COUPLES ATTENDING TERTIARY CARE CENTRE OF RURAL BIHAR

2021 ◽  
pp. 81-83
Author(s):  
Rashmi Verma
Keyword(s):  
Tertiary Care ◽  
Semen Parameters ◽  
Polycystic Ovaries ◽  
Male Factor ◽  
Unprotected Sexual Intercourse ◽  
Male And Female ◽  
Primary Infertility ◽  
Ovulatory Dysfunction ◽  
Uterine Anomalies ◽  
High Level

Background:Infertility is a life crisis affecting patients from all around the world. It is a disease of the reproductive system dened by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. Worldwide, its prevalence is approximately 8-12%. Aim:To determine the causes and clinical pattern of infertility in couples based on clinical and laboratory nding Methods: It was hospital based observational study carried out in the department of Obstetrics and Gynaecology of Katihar Medical College and Hospital, from Feb 2019 to Jan 2020. 300 women were selected for the study with the diagnosis of infertility and 36 of them were lost to follow up so 264 women were enrolled in the study Result: Out of 300 women, 264 had all the data and they participated in the study. Maximum women (50%) were in age group 20-29 yrs. The median duration of marriage was 5 yrs. Primary infertility was in 70% women and 30% women presented with secondary infertility. Female factor was found in 48.1% cases, 15.2% cases had only male factor, 28% having both male and female factor whereas 8.7% cases were with unexplained infertility. Features of polycystic ovaries and ovulatory dysfunction were found in 14.4% women. Adnexal pathology was seen in 10% cases, uterine broid detected in 10.6% cases and uterine anomalies were found in 1.5% cases. High level of TSH (TSH≥4) were found in 32 (12.1%) women and 14 women (5.3%) diagnosed with hyperprolactinemia (≥25ng/ml). Approx. 3.4% women were found to have high level of FSH≥10, whereas LH was raised in 2.3% cases. 14.4% male had abnormal semen parameters. Common abnormalities were azoospermia 6% and oligozoospermia in 3.8% and asthenospermia in 4.5% cases. Conclusion: Primary infertility cases are more common with female factor predominance over male factor. Ovulatory dysfunction, tubal pathology, hormonal imbalance and abnormal semen parameters were main contributing factor for infertility. Male and female both factors are responsible for infertility. So, both partners should be counselled and investigated properly.

STUDY OF DISTRIBUTION OF REPRODUCTIVE TRACT ANOMALIES IN INFERTILE WOMEN THROUGH HYSTEROSALPINGOGRAPHY IN CENTRAL INDIA

2021 ◽  
pp. 11-12
Author(s):  
Santoshkumar Bhise
Keyword(s):  
Reproductive Tract ◽  
Tertiary Care ◽  
Uterine Cavity ◽  
Central India ◽  
Reproductive Age ◽  
Care Hospital ◽  
Fallopian Tubes ◽  
Observation Study ◽  
Secondary Infertility ◽  
Infertile Women

Context:Infertility has risen to be a public health problem in India, National Family Health Survey (NFHS) – 4 estimates showing 5.2% of the women in reproductive age group to be infertile. Infertility can be due to male factors, female factors and in some cases unexplained; female factors comprising of 40-45% of the total cases. Amongst the female factors anatomical congenital anomalies as well as acquired abnormalities of the reproductive tract may cause primary or secondary infertility. Aims: This study aimed at looking at the distribution of congenital anatomical anomalies of the uterus and fallopian tubes as well as the distribution of anatomical changes in uterus and fallopian tubes due to pathological conditions through Hysterosalpingograhy (HSG) in infertile women. Methods & Materials: 103 women attending Obs. and Gyneac. OPD for diagnosis and treatment of infertility in a tertiary care hospital in Central India were selected in this observation study. Sampling was purposive. HSG was performed and the data was obtained from the department of radiology. Descriptive analysis was done, and where applicable bi-variate analysis was done with chi-square test. Results:There were 63 cases of primary (mean age = 25 years ± 3.2) and 40 cases of secondary infertility (mean age = 30 years ± 2.9). 24% of the total cases had tubal occlusion, 16.5% had hydrosalpinx, 4% had arcuate and bicornuate uterus each and 1 % had unicornuate uterus, lling defects in uterus, deviation of uterine cavity, T-shaped uterus and sub-mucous broid each. 47% of the cases had normal HSG ndings. Conclusions: The results show that acquired causes of tubes were most common ndings in HSG of infertile women, pointing to preventable and easily manageable cases of infections of reproductive tract. Timely management of such cases at primary health care level can help reduction of infertility cases.

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