Role of Endometrium Biopsy and Hystero-laparoscopy in Evaluation of Female Infertility

Reproductive health problems are a major concern in developing nations, with infertility being one of the most significant issues that often goes unnoticed, it is estimated that 10-15% of couples struggle with infertility. Identifying the root cause of infertility can be a complex process, and even after a thorough evaluation, 20-30% of couples may remain unsure of the cause. Despite the potential risks associated with the procedure, diagnostic hystero laparoscopy is considered the gold standard for treating female infertility due to its diagnostic and therapeutic benefits. This method offers high diagnostic accuracy and provides definitive treatment options for abnormalities in the uterus, tubes, and pelvis that may be missed by other imaging techniques. This study aimed to investigate the use of endometrial biopsy following hysteroscopy and laparoscopy, along with histopathological assessment, to identify the causes and abnormalities associated with female infertility. Laparoscopy revealed that the most common abnormality was tubal pathology in 19 (38%) patients, followed by endometriosis in 5 (10%) patients, myoma in 1 (2%) patient, adhesion in 13 (26%) patients, anomalous uterus in 3 (6%) patients, and PCOD in 4 (8%) patients. In 10% of patients, no anomalies were detected. The most common abnormalities identified in laparoscopy for both primary and secondary infertility were tubal pathology (28% and 10%, respectively), followed by adhesion (22% and 4%, respectively). Hysteroscopy findings were significantly associated with fertility outcomes in patients. diagnostic hystero laparoscopy is a highly effective diagnostic and therapeutic approach that can help women achieve successful outcomes in the treatment of infertility.