Results of 2500 office-based diagnostic hysteroscopies before IVF

Abstract

The aim of the study is to assess the diagnostic accuracy, findings and feasibility of office-based diagnostic hysteroscopy in an IVF population. A total of 2500 consecutive infertile patients were enrolled prospectively prior to IVF treatment. Diagnostic hysteroscopy was performed on each subject in an office setting in the study IVF centre. A total of 1927 patients (77.1%) had a normal uterine cavity, while the remainder of the sample (n=573) demonstrated endometrial pathology on hysteroscopy (22.9%). Of the patients with endometrial pathology, 192 patients had endometrial polyps (7.68%), 96 patients had submucosal fibroids (3.84%), 31 patients had polypoid endometria (1.24%), 27 patients had intrauterine adhesions (1.08%) and 73 patients had uterine septa (2.92%). Diagnostic office-based hysteroscopy is routinely performed in the IVF clinic to assess the endometrial cavity. In such an unselected population, a significant percentage of patients had evidence of uterine pathology that may have impaired the success of IVF. Safety, ease of use, high diagnostic accuracy and high patient tolerance makes office-based hysteroscopy an ideal procedure.

Office hysteroscopy prior to ART cycle-analysis and outcome at a private IVF clinic setup in Surat, Gujarat, India

“…Endometrial pathology on hysteroscopy which may have impaired the success of IVF was identified in 22.9%. 12 Karayalcın et al enrolled 1258 patients attending an IVF clinic with normal hysteroscopic findings in an attempt to establish the impact of timing of office hysteroscopy before embryo transfer on pregnancy rate. The implantation, pregnancy, and clinical pregnancy rates were significant when office hysteroscopy was performed 50 days or less before embryo transfer.…”

The Usefullness of Office Hysteroscopy in Evaluation of Infertil Women Prior to In Vitro Fertilization Cycles

“…Daha önce yapılan çalışma-larda bu oran %11-45 arasında bildirilmiştir. 3,4 Sonuçları hasta populasyonunun yaşı, hormonal durumları, etnik faktörler ve infertilite tipi de etkileyebilir. Çalışmaların çoğunda IVF öncesi ofis histeroskopi ile saptanmış olan anormal bulguların oranı verilmiş olmasına rağmen, bu patolojik bulguların tedavi edilmesi sonucunda fayda gören ve gebe kalan hastaların oranlarından bahsedilmemektedir.…”

“…2 Gözardı edilmemesi gereken, bu uterin kaynaklı patolojilerin sıklığının yapılan çalışma-larda %11-45 oranında bulunmasıdır. 3,4 Bu patolojilerin ekarte edilebilmesi için kavitenin çok iyi bir şekilde değerlendirilmesi gerekmektedir.…”

Chromohysteroscopy after failed intracytoplasmic sperm injection

“…[18][19][20] Fatemi et al) and Karayalcin et al demonstrated that uterine cavity abnormalities in their study population were low (11% for the 1st one and 22.9% for the 2nd one) while Gaviño-Gaviño et al found very high incidence of uterine pathology in their studies (64%) with repeated IVF failure. [21][22][23] Despite these drawbacks of non-using hysteroscopy before ICSI, many IVF clinics were reluctant in use of hysteroscopy for uterine cavity evaluation for difficulty or cost. However, office hysteroscopy with small diameter sheath (3-5 mm), using the non-touch (vaginoscopic) technique with low pain score encouraged ICSI centers to start to do hysteroscopy as outpatient procedure.…”