الفهرس | Only 14 pages are availabe for public view |
Abstract This prospective observational study was carried out in Obstetrics and Gynecology Department at Tanta University Hospital. It was conducted during the period from June 2018 to May 2019. The study included 100 patients who suffered from infertility either primary or secondary. The aim of the study was to find out whether hysteroscopy has a great value with laparoscopy and should be done routinely during infertility work up or not. All patients were submitted to full history taking, detailed clinical examination, ultrasound evaluation (trans-abdominal and trans-vaginal), hormonal profile assessment and HSG. All causes of infertility diagnosed by both hysteroscopy and laparoscopy were collected, statistically analyzed and tabulated. Hysteroscopy was beneficial in diagnosis of multiple causes of infertility like intrauterine septum, myoma, polyps, blocked Ostia, abnormal endometrium and intrauterine synechae. It showed different incidence of these causes among the randomly choses 100 patients. It showed greater value in diagnosis than HSG. Many causes of infertility were missed by HSG were missed while they were easily diagnosed with hysteroscopy with its extra privilege of direct visualization and magnification abilities. So, it is recommended that HSG should be a good indicator of intrauterine anomaly that should be done before hysteroscopy is done but, it should not be used as single method of diagnosis. Laparoscopy had the greatest importance in diagnosis of causes of infertility that were outside the uterine lumen. It was helpful in diagnosis of pelvic adhesions, endometriosis, myoma, PCOS, tubal pathology and uterine anomalies. So, laparoscopy is a corner stone of infertility work up especially in cases that is hard to be diagnoses with simple methods. Finally, if we compare results of our present study with results of similar studies mentioned in the discussion chapter, we will find that they all agree on the great value of hysteroscopy as a method of diagnosis during infertility work up and it is highly recommended to be done as a routine procedure with laparoscopy. |