The Combination Of Hysteroscopy And Laparoscopy In Diagnosis And Treatment Of Female Infertility

Objective: To investigate the value of combinated use of hysteroscopy and laparoscopy in diagnosis and treatment of female infertilityMaterials and Methods: From June 2007 to March 2009,135 cases with infertility were diagnosed and treated under hysteroscopy combined with laparoscopy.Then their etiological factors were diagnosed and pertinently treated. Systematic review of these clinical dataResults:1. By laparoscopy,123 cases of pelvic diseases were found,including 70 cases of pelvis inflammation,40 cases of endometriosis,6 cases of polycystic ovarian syndrome,6 cases of ovarian cyst,5 cases of hysteromyoma,and 2 case of pelvis phymatiosis.By using hysteroscopy,21 cases of uterine cavity diseases were revealed.13 cases were detected by both laparoscopy and hysteroscopy.2. The causes of pelvic adhesion:56 cases pelvic inflammation(65.11%), 29 cases endometriosis(33.72%),1 cases pelvic tuberculosis (1.16%).3. Before the operation,totally 256 abnormal fallopian tubes,including 102 tubes of salpingemphraxis,48 partial salpingemphraxis and 94 completely unobstructed,were detected in the patients.After the operation,tubal patency tests showed that the numbers changed into 33,28,and 195 respectively.The patency rate of the surgery was 61.8%(99/160).4.In the patients,45 cases were lost to follow up,The other 89 cases were followed up for 2 years,during which 32 women were pregnant(41.55%) and 2 cases of tubal pregnancy.5. The accuracy of HSG was compared with that of chromotubation under laparoscopy,the false positive rate of HSG is 19.2%,the false negative rate is 48.9%,the sensitivity is 51.1%,the specificity is 80.8% ,and the accuracy rate of HSG is 66.7%.Conclusion:Laparoscopy combined with hysteroscopy is a valuable method in the diagnosis and treatment of female infertility. Under one anesthesia,they can examine the pelvic and uterine directly and accurately,determine the causes of infertility,then treat it,and the most important thing is that it can markedly increase the rate of pregnancy. These kind of procedure is valuable and should be encouraged to be performed.