The New Indian Journal of OBGYN. 10(1):172-177

Hysteroscopic evaluation of uterine pathology in women with infertility in a tertiary care hospital

Shaidul Islam Borah, Hem Kanta Sarma, Tanmoy Deka, Bhargav Chaliha, Sarat Das

ABSTRACT

Objectives: To evaluate the efficacy of hysteroscopy in relation to histopathological examination in women with infertility in diagnosing intrauterine pathology. Methods: This hospital based cross sectional study was carried out at department of Obstetrics and Gynaecology, JMCH, Jorhat over a period of one year. 60 infertile women with either primary or secondary infertility were taken up for study. Hysteroscopy was performed by using 2.9mm 300 Volksman hysteroscope. Data was collected from the medical records department of the hospital and infertility register of Gynaecology OPD. Results: Among 60 infertile women 41 had primary amenorrhea and 19 had secondary amenorrhea. Majority of primary infertility group (41.5%) belonged to 20-25 years of age and 31.6% of secondary infertility cases presented in 31-35 years of age. 51.2% of primary infertility patients presented with 1-5 years duration and 84.2%of secondary infertility cases with 6-10 years duration of infertility. Majority (51.7%) has normal menstrual cycle and rest has irregular cycle.18.3% has low FSH, LH, E2 which implies ovulatory dysfunction and 13.3% has hypothyroidism. Diagnostic hysteroscopy shows abnormal findings in 18 cases. Fibroid was presented in 16.7%, endometrial polyp in 5%, intrauterine adhesion in 3.3%% of infertility patients. Uterine anomalies were presented in 5% cases. Among the patients, where tissue was sent for HPE after hysteroscopic diagnosis 94.1% had similar findings in HPE compared to hysteroscopy. Conclusion: Diagnostic hysteroscopy is a definitive daycare procedure in evaluation of infertility. It helps in the diagnosis of specific causes of infertility, which is not diagnosed by other investigations like hormonal study, USG and HSG.