Evaluating Infertility Through Diagnostic Hysterolaparoscopy: A Prospective Study.

Background Infertility affects a significant proportion of reproductive-age couples globally, with diverse causes. Diagnostic hystero-laparoscopy (DHL) is emerging as a preferred diagnostic tool for evaluating infertility, combining laparoscopy and hysteroscopy for comprehensive assessment. Objective The primary objective of this prospective study was to evaluate the diagnostic accuracy and clinical utility of DHL in identifying the causes of infertility in women. Secondary objectives included assessing complication rates associated with the procedure and comparing the efficacy of DHL with other diagnostic modalities to determine its relative benefits and safety in clinical practice. Methods Fifty female patients (ages 20-40 years) experiencing primary or secondary infertility were enrolled from the Outpatient Department of the tertiary care center. Patients were selected based on specific inclusion and exclusion criteria. Informed consent was obtained, and detailed medical histories were recorded. All participants underwent DHL, assessing uterine, tubal, and ovarian factors contributing to infertility. Results Of the 50 patients, 36 (72%) had primary infertility and 14 (28%) had secondary infertility. The predominant age group for primary infertility was 26-30 years (16 patients, 44.4%), while secondary infertility was most common in the 31-35 age group (7 patients, 50%). Tubal factors accounted for 18 cases (36%), while ovarian issues were identified in 15 cases (29.8%). Uterine factors were found in five cases (11.1% for primary, 7.14% for secondary). DHL also identified uterine pathologies that may lead to pregnancy complications. Conclusions The study underscores the multifactorial nature of infertility, highlighting the importance of DHL in its evaluation. The findings advocate for advanced diagnostic techniques to facilitate targeted treatments and enhance reproductive outcomes.