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Transvaginal hydrolaparoscopy: investigation of infertility in a Portuguese tertiary referral centre

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Author(s): Andrea Marinho Silva Quintas

Journal: Acta Obstetrica e Ginecologia Portuguesa
ISSN 1646-5830


ABSTRACT
OVERVIEW: Transvaginal hydrolaparoscopy (THL) is a powerful tool for infertility evaluation, involving a combination of different minimally invasive techniques. It allows a unique and most thorough exploration of the reproductive tract, while also performing some therapeutic interventions. STUDY DESIGN: Retrospective observational study.METHODS: The clinical files of infertile women in whom THL was attempted were reviewed, with analysis of the indications, clinical findings, therapeutic interventions and complications.RESULTS: From August 2001 to June 2009, THL was attempted in 102 infertile women, 33 of whom had polycystic ovary syndrome (PCOS). Access to the Douglas pouch was successful in 97.1% of cases. Complete visualization was accomplished in 94 patients (94.9%). The most common clinical findings were polycystic ovaries stigmata (20.1%) tubo-ovarian adhesions (15.7%), and small deposits of endometriosis (7.8%). Adhesiolysis was performed in 16.2% of patients. Hysteroscopy was performed in all women and dye test for tubal patency in 96.1%. There was unilateral tubal occlusion in 16.3% and bilateral in 6.1%. Ovarian drilling was performed in all patients with PCOS. Pregnancy in vivo was achieved in 48.3%. In 11.1% of women, elective operative laparoscopy was proposed.

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