Combined laparoscopy and hysteroscopy for the detection of female genital system anomalies results of 3,811 infertile women.

OBJECTIVE

To assess the prevalence of Mullerian and gonadal anomalies in a group of infertile women using a combination of diagnostic laparoscopy and hysteroscopy.

STUDY

DESIGN

This was a retrospective descriptive study in the setting of a university hospital. The records of 3,811 women who underwent laparoscopy and hysteroscopy for infertility were reviewed.

RESULTS

Mullerian duct anomalies (MDAs) were diagnosed in 287/3,811 (7.5%) women, gonadal anomalies in 40/3,811 (1.04%) women, MDAs and gonadal anomalies in 22/3,811 (0.57%) women, and "undefined anomalies" in 8/3,811 (0.2%) women. Among the 287 women with MDAs 54.9% were diagnosed with a septate uterus, 14.2% with an arcuate uterus, 10.2% with a bicornuate uterus, 5.8% with a unicornuate uterus, 4.7% with tubal anomalies, 3.6% with a hypoplastic uterus, 2.9% with Mullerian agenesis, 1.8% with a septate uterus and a double cervix, 1.1% with uterus didelphys, and 0.7% with a longitudinal vaginal septum. Among the 40 women with gonadal anomalies 70% were diagnosed with hypoplastic ovaries, 25% with streak gonads, and 5% with an accessory ovary. Among the 22 women with combined Mullerian and gonadal anomalies 50% were diagnosed with streak gonads and a hypoplastic uterus, 31.8% with a hypoplastic uterus and hypoplastic ovaries, and 18.2% with ovarian and tubal anomalies.

CONCLUSION

Combined laparoscopy and hysteroscopy are valuable tools for the diagnosis and classification of female genital system anomalies.