Predictors for Successful Pregnancy Following Hystro-Laparoscopic Intervention among Infertile Females: A Cohort Study

Rafal Mustafa Murshid; Wasan Nori; Reshed Zeki Obaid; Wisam Akram

doi:10.54133/ajms.v7i1.1016

Authors

Rafal Mustafa Murshid Department of Obstetrics and Gynecology, College of Medicine, University of Anbar, Ramadi, Iraq
Wasan Nori Department of Obstetrics and Gynecology, College of Medicine, Mustansiriyah University, Baghdad, Iraq https://orcid.org/0000-0002-8749-2444
Reshed Zeki Obaid Department of Obstetrics and Gynecology, College of Medicine, University of Anbar, Ramadi, Iraq
Wisam Akram Department of Obstetrics and Gynecology, College of Medicine, Mustansiriyah University, Baghdad, Iraq https://orcid.org/0000-0002-1968-7004

DOI:

https://doi.org/10.54133/ajms.v7i1.1016

Keywords:

Adhesion, Clinical pregnancy, Hystro-laparoscopy, Infertility, Ovarian drilling, Tubal block

Abstract

Background: Infertility is a major medical and sociopsychological problem that impacts a couple's life. Investigations help guide therapeutic intervention by exploring underlying causes. Hysteroscopy can identify and treat intrauterine pathologies such as adhesion, septum, and endometrial polyps. Laparoscopy has a diagnostic and therapeutic role in the pelvic cavity, including tubal blockage, pelvic adhesions, endometriosis, and polycystic ovaries. Objective: To evaluate the value of combined hystro-laparoscopic interventions in managing female infertility and to explore predictors for a successful pregnancy. Methods: A retrospective cohort study enrolled (142) eligible females who underwent hystro-laparoscopy. Participants' demographic criteria were recorded. Additionally, intraoperative interventions (hysteroscopic removal of the polyp and septum) and laparoscopic removal of pelvic adhesions, removal of the chocolate cyst, ovarian drilling and laparoscopic chromotubation). All patients were followed up for six months. Logistic regression and odd ratio were used to assess the intervention's reliability in predicting pregnancy. Results: Clinical pregnancy was reported in 48/142, with a success rate of 33.8%. Pregnant women had significantly lower ages and lived in urban areas. Laparoscopic adhesion removal and tubal block correction reliably predicted clinical pregnancy, with adjusted odds ratios (AOR) of 0.25; 95% CI (0.08–0.78) and 0.40; 95% CI (0.16-0.98), respectively. None of the hysteroscopic interventions was statistically significant. Conclusions: Because hystero-laparoscopic procedures improve the chances of getting pregnant and are minimally invasive, they are an important part of fertility workups and can be used to diagnose and treat fertility problems.

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