Clinical Effect of Transvaginal Hydrolaparoscopy Combined with Hysteros-copy in the Diagnosis and Treatment of Infertility and Its Impact on the Stress Response of the Body

HAN Ci; HU Xiaoli; ZHEN Yinzhi; YE Jing; HU Xueyan; ZHANG Xin; ZHANG Yu

doi:10.3969/j.issn.1002-3429.2025.07.010

Abstract：Objective To explore the clinical effect of transvaginal hydrolaparoscopy(THL)combined with hysteros-copy in the diagnosis and treatment of infertility and its impact on the stress response of the body.Methods A total of 322 female infertile patients treated from July 2021 to January 2023 were selected as the observation subjects.According to differ-ent examination methods,they were divided into the combination group and the angiography group,with 161 patients in each group.The combination group was treated with THL combined with hysteroscopy,and the angiography group was treated with hysterosalpingography.The consistency of two examination methods in the diagnosis of fallopian tube patency,pelvic abnor-malities and pregnancy within 1 year of follow-up were recorded and compared.The severity of pain[visual analogue scale(VAS),Wong-Baker FACES pain rating scale score],stress response indexes[adrenocorticotropic hormone(ACTH),nora-drenalin(NA),angiotensinⅡ(AⅡ),cortisol(Cor)],and the incidence of complications were compared between the two groups.Results The proportion of bilateral patency of fallopian tubes in the combination group was higher than that in the angiography group,and the proportion of bilateral obstruction was lower than that in the angiography group(P＜0.05).The Kappa test showed that there was a significant difference in the consistency evaluation of different examinations in the diagnosis of tubal patency(P＜0.01).The total positive rate of the examination of pelvic abnormalities in the combination group was 83.23%(134/161),which was higher than44.10%(71/161)in the angiography group(P＜0.05).Within 1 year of fol-low-up,the natural intrauterine pregnancy rate of the combination group was higher than that of the angiography group,and the non-pregnancy rate was lower than that of the angiography group(P＜0.05).There were no significant differences in the as-sisted reproductive pregnancy rate,abortion rate and ectopic pregnancy rate between the two groups(P＞0.05).The levels of ACTH,NA,AⅡ and Cor in the two groups after surgery were higher than those before surgery,while the levels of ACTH and Cor in the combination group after surgery were lower than those in the angiography group(P＜0.05).The Wong-Baker FACES pain rating scale score and postoperative VAS score of the combination group were significantly lower than those of the angiography group(P＜0.05).The incidence of complications in the combination group was 8.07%(13/161),which was lower than 27.33%(44/161)in the angiography group(P＜0.05).Conclusion THL combined with hysteroscopy in the clinical diagnosis and treatment of infertility can not only directly observe the pelvic and uterine cavity abnormalities,accurate-ly judge the fallopian tube,but also treat endometrial polyps,intrauterine adhesion,pelvic adhesion and other lesions,with high safety and light stress response,so as to shorten the diagnosis and treatment cycle of female infertile patients.