Timing and Values of Laparoscopy in Infertile Women with Normal Hysterosalpingography

Objective: To verify the current practice of postponing laparoscopy after a normal HSG in infertile couples with no evident cause of infertility, aiming at reducing the need for interventional investigations thus decreasing cost and risk. Study Design: Case series study including three hundred and thirty women. Patients and Methods: The women were categorized into two groups as follows: Group (1): 200 women with normal hysterosalpingography and undergoing laparoscopy for investigating infertility. Group (2): 130 women undergoing hysterosalpingography as part of their infertility workup, with no obvious cause for infertility and scheduled to have diagnostic laparoscopy after 6 months of follow-up. They were studied for at Kasr El Ainy Maternity Hospital from April 2013 to April 2014. Results: By comparing retrospective and prospective groups, it was found that incidence of fallopian tube abnormalities was more in group (2) (55%) than in group (1) (35%) and the incidence of change of diagnosis post operatively is markedly higher in group (2) (75%) than group (1) (42%) this may be due to the presence of follow-up in group (2). Conclusions: In infertile women with normal hysterosalpingography, laparoscopy is better not performed before 6 months after normal hysterosalpingography because of potential therapeutic effect of hysterosalpingography. Also laparoscopy is better to be performed after a normal hysterosalpingography if pregnancy has not occurred by 6 months because of high incidence of pelvic pathology.