Do accessory parameters affect the outcome of the endoscopic procedures in female infertile patients?: an experience at a single tertiary care center

Authors

  • Namita Agrawal Department of Obstetrics and Gynecology, Santokba Durlabhji Memorial Hospital, Jaipur, Rajasthan, India
  • Poonam Yadav Department of Obstetrics and Gynecology, Santokba Durlabhji Memorial Hospital, Jaipur, Rajasthan, India
  • S. Fayyaz Department of Obstetrics and Gynecology, Santokba Durlabhji Memorial Hospital, Jaipur, Rajasthan, India
  • Tarun Kumar Jain Department of Obstetrics and Gynecology, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20191966

Keywords:

Age, Body mass index, Duration of infertility, Fetal Hysterolaparoscopy, Hemoglobin level, Infertility, Pregnancy

Abstract

Background: In modern era, endoscopic methods are commonly used in evaluation of female infertility. Hysterolaparoscopy is such a real time theranostic modality for anatomical causes of the infertility. The objective of this study was to evaluate the effect of accessory parameters (Age, Body mass index, duration of infertility, Rhesus factor, menstruation history and hemoglobin) on success rate of endoscopic procedures in terms of achieving pregnancy.

Methods: A total 157 female infertile patients (Mean± standard deviation 27.72±3.82 years) were recruited in present study. During initial assessment detailed history was taken and hysterolaparoscopy was performed. The observed structural abnormalities on hysterolaparoscopy during diagnostic work up were tackled at same time if possible. After procedure, patients were counselled for regular sexual activity. The follow-up of all patients was done for 12 months.

Results: A total 157 female infertile patients were recruited and divided into primary 93 (59.2%) and secondary infertile 64 (41.74%) patients on basis of obstetric history. The average age, BMI, hemoglobin and duration of infertility were 27.7years, 21.8 kg/m2, 12.3 gm and 3.9 years respectively. Out of 157 patients, anatomical abnormalities were detected in 125 patients during Hysterolaparoscopy and distributed in 77/93 (82.8%) primary and 48/64 (75%) secondary infertile patients. Of 125 patients with abnormal hysterolaparoscopic findings, 121 underwent active intervention and on follow up, 43 patients were conceived. We found that age; BMI, Rhesus factor, menstruation history and duration of the infertility were not correlated with fertility outcome while hemoglobin level was significantly correlated with conception rate.

Conclusions: Authors concluded that outcome of the hysterolaparoscopy in female infertile patients is significantly depends upon hemoglobin levels, however outcome is irrelevant to age, duration of infertility, Rhesus factor and body mass index.

References

Agrawal N, Yadav P, Fayyaz S, Kaur B. Is hysterolaparoscopy a real theranostic approach for anatomical barriers in female fertility? A future argument. Int J Reprod Contracept Obstet Gynecol. 2018;7:2423-8.

National Collaborating Centre for Women’s and Children’s Health. Fertility: assessment and treatment for people with fertility problems. London, United Kingdom: National Institute for Health and Clinical Excellence (NICE); 2013:1-63.

Practice Committee of American Society for Reproductive Medicine. Diagnostic evaluation of the infertile female: a committee opinion. Fertil Steril. 2012; 98(2):302-7.

Agrawal N, Sharma R. Correlation of Anti-Müllerian hormone with clinical, hormonal and ultrasonographic parameters in PCOS and normo-ovulatory women: an experience of single tertiary care center. Int J Gynaecol Obstet. 2018;30(4):2385-0868.

Agrawal N, Fayyaz S. Can hysterolaparoscopic mediated chromopertubation obviate the need for hysterosalpingography for proximal tubal blockage?: An experience at a single tertiary care center. J Gynecol Obstet Hum Reprod. 2018.

Agrawal N, Fayyaz S. Evaluation of endoscopic procedures in terms of achieving pregnancy in female infertile patients: an experience at a single tertiary care center. J Gynecol Obstet Hum Reprod. 2018.

The Practice Committee of the American Society for Reproductive Medicine: Vaccination guidelines for female infertility patients. Fertil Steril. 2008;90(5):S169-71.

The ESHRE Capri Workshop Group: Diagnosis and management of the infertile couple: missing information. Hum Reprod Update. 2004;10(4):295-307.

Jose-Miller AB, Boyden JW, Frey KA. Infertility. Am Fam Physician. 2007;75(6):849-56.

Macaluso M, Wright-Schnapp TJ, Chandra A, Johnson R, Satterwhite CL, PulverA, et al. A public health focus on infertility prevention, detection, and management. Fertil Steril. 2010;93(1):16.e1-10.

Vayena E, Peterson H, Adamson D, Nygren KG. Assisted reproductive technologies in developing countries: are we caring yet? Fertil Steril. 2009;92(2):413-6.

Vaid K, Mehra S, Verma M, Jain S, Sharma A, Bhaskaran S. Pan endoscopic approach "hysterolaparoscopy" as an initial procedure in selected infertile women. J Clin Diagn Res. 2014;8(2):95-8.

Agrawal N, Fayyaz S. Does type of intervention affects the endoscopic procedure outcome in female infertile patients? an experience at a single tertiary care centre. Int J Reprod Contracept Obstet Gynecol. 2019;8:192-9.

Hassa H, Aydin Y. The role of laparoscopy in the management of infertility. J Obstet Gynaecol. 2014;34(1):1-7.

American College of Obstetricians and Gynecologists Committee on Gynecologic Practice and Practice Committee. Female age-related fertility decline. Committee Opinion No. 589. Fertil Steril. 2014;101(3):633-4.

Pandey S, Pandey S, Maheshwari A, Bhattacharya S. The impact of female obesity on the outcome of fertility treatment. J Hum Reprod Sci. 2010;3(2):62-7.

Giviziez CR, Sanchez EG, Approbato MS, Maia MC, Fleury EA, Sasaki RS. Obesity and anovulatory infertility: A review. JBRA Assist Reprod. 2016;20(4):240-5.

Spitzer D, Corn C, Stadler J. Implications of Blood Type for Ovarian Reserve and Infertility - Impact on Oocyte Yield in IVF Patients. Geburtshilfe Frauenheilkd. 2014;74(10):928-32.

Wise LA, Mikkelsen EM, Rothman KJ. A prospective cohort study of menstrual characteristics and time to pregnancy. Am J Epidemiol. 2011;174(6):701-9.

Iron status and reproduction in US women: National Health and Nutrition Examination Survey, 1999-2006. PLoS One. 2014;9(11):e112216.

Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC. Iron intake and risk of ovulatory infertility. Obstet Gynecol. 2006;108:1145-52.

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Published

2019-04-29

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Original Research Articles