Comparative study on the role of diagnostic hysteroscopy in evaluation of the uterine cavity prior to in vitro fertilization in a developing country

Arch Gynecol Obstet. 2013 Nov;288(5):1137-43. doi: 10.1007/s00404-013-2842-8. Epub 2013 Apr 20.

Abstract

Introduction: Diagnostic hysteroscopy is a vital tool and a gold standard to evaluate the uterine cavity. The aim of this study was to estimate the prevalence of unsuspected intrauterine abnormalities.

Materials and methods: This cross-sectional study was done involving 870 asymptomatic, infertile women enrolled for IVF, who underwent a transvaginal ultrasound followed by office hysteroscopy. The presence of uterine cavity abnormalities was recorded.

Results: Transvaginal sonography revealed abnormal findings in 113 patients (12.9 %). Hysteroscopy confirmed the ultrasound findings in 76 (67.3 %) women with no obvious findings seen on hysteroscopy in 37 (32.7 %). Among the 757 women, who had a normal pelvic scan, abnormal findings were observed in 108 (14.2 %) on hysteroscopy, while the remaining 649 (85.7 %) patients had normal findings on hysteroscopy. Thus, a total of 184 (21.1 %) patients had confirmed abnormalities that required to be treated before performing IVF/ICSI.

Conclusions: The present study highlights the relatively higher prevalence of intrauterine abnormalities in our patient population. Diagnosing and treating these abnormalities are imperative to improve the success of IVF treatment. Therefore, a routine diagnostic hysteroscopy in these patients becomes mandatory before proceeding with expensive procedures such as assisted reproduction.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Developing Countries*
  • Female
  • Fertilization in Vitro
  • Humans
  • Hysteroscopy*
  • India
  • Leiomyoma / diagnostic imaging
  • Leiomyoma / pathology*
  • Polyps / diagnostic imaging
  • Polyps / pathology*
  • Prospective Studies
  • Tissue Adhesions / diagnostic imaging
  • Tissue Adhesions / pathology
  • Ultrasonography
  • Uterine Neoplasms / diagnostic imaging
  • Uterine Neoplasms / pathology*
  • Uterus / abnormalities*
  • Uterus / diagnostic imaging
  • Uterus / pathology*