Background: There is no uniform definition for unexplained infertility, and this varies depending on the duration of infertility and the age of the female partner. The laparoscopy plays an important role in evaluation of infertile women as it a better predictor of future fertility. Hysteroscopic procedures are highly appreciated mainly for their minimal invasiveness, suitability for office gynecology, cost effectiveness and safety.laparoscopy and hysteroscopy is considered the gold standard for evaluation infertility as the advantages of combined hysteroscopic and laparoscopic approach are proper assessment of the distal tubes and ovaries, the elimination of tubal spasm as a factor of infertility, absence of radiation, more precise application of instruments and confirmation of achievement of tubal patency during the procedure.
Aim: This study was done to evaluate the role of diagnostic hysterolaparoscopy in the comprehensive work up of unexplained infertility, which would help in planning appropriate management.
Methodology: In the current study, we selected 168 women with unexplained infertility. The mean age of the studied group was 30.3 ± 4.3 years. The mean duration of infertility was 5.3 ± 1.7 years; ranging between 1.5 and 9 years. As hysteroscopy provides direct visual to the uterine cavity and laparoscopy inspects the pelvic cavity, we ask the question; Do hysteroscopy and/or laparoscopy add to the infertility work-up? At this study during hysteroscopic evaluation for the (168) studied patients with unexplained infertility, we reported that 68 (40.4%) of patients had normal uterine cavity and 100 (59.5%) of patients had abnormal uterine cavity.
Conclusion: In conclusion hystero-laparoscopy is benefitial in the work-up of patients with unexplained infertility and normal H.S.G findings because it has been demonstrated to be a reliable procedure in detecting infertility causes in the uterus and pelvic cavity that had not been previously detected by routine infertility work-up and that could then treat allowing post-operative pregnancies.