Role of Diagnostic Hysterolaproscopy in Infertility Management at Tertiary Care Hospital in South India

Background: Infertility affects approximately 10–15% of reproductive-age couples, with female factors contributing significantly. Diagnostic hysterolaparoscopy (DHL) is considered the gold standard for evaluating tubal patency and detecting pelvic and uterine pathologies that may not be identified by routine clinical examination or ultrasonography.

Objective: To evaluate the role of diagnostic hysterolaparoscopy in the assessment and management of female infertility in a tertiary care hospital.

Methods: A retrospective observational study was conducted among 82 women aged 20–40 years who underwent diagnostic hysterolaparoscopy for infertility evaluation between May 2020 and February 2023 at Dr. B. R. Ambedkar Medical College and Hospital. Data were retrieved from medical records and analyzed using SPSS software. Clinical characteristics and hysteroscopic and laparoscopic findings were assessed.

Results: Primary infertility was observed in 73.2% of women, while 26.8% had secondary infertility. The mean age was 27.2 ± 2.6 years, and most patients (56.1%) belonged to the 25–29-year age group. The majority (87.8%) had infertility of ≤5 years' duration. Overweight and obesity were present in 57.3% and 14.6% of patients, respectively. Laparoscopic abnormalities were more frequent than hysteroscopic abnormalities, with tuboperitoneal pathology being the predominant finding. Bilateral peritubal adhesions and hydrosalpinx were the most common abnormalities. The most common hysteroscopic finding was an endometrial polyp. Simultaneous therapeutic procedures such as adhesiolysis and ablation of endometriotic lesions were performed whenever indicated.

Conclusion: Diagnostic hysterolaparoscopy is a valuable minimally invasive procedure for the comprehensive evaluation of female infertility. It facilitates the diagnosis of occult pelvic and intrauterine pathologies while allowing simultaneous therapeutic intervention, thereby improving clinical management of infertile women, particularly in resource-limited settings