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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Balmaceda JP, Ciuffardi I (1995) Hysteroscopy and assisted reproductive technology. Obstet Gynecol Clin North Am 22:507–518
La Sala GB, Montanari R, Dessanti L, Cigarini C, Sartori F (1998) The role of diagnostic hysteroscopy and endometrial biopsy in assisted reproductive technologies. Fertil Steril 70:378–380
Hinckley MD, Milki AA (2004) 1000 office-based hysteroscopies prior to in vitro fertilization: feasibility and findings. JSLS 8:103–107
Shamma FN, Lee G, Gutmann JN, Lavy G (1992) The role of office hysteroscopy in in vitro fertilization. Fertil Steril 58:1237–1239
Oliveira FG, Abdelmassih VG, Diamond MP, Dozortsev D, Nagy ZP, Abdelmassih R (2003) Uterine cavity findings and hysteroscopic interventions in patients undergoing in vitro fertilization-embryo transfer who repeatedly cannot conceive. Fertil Steril 80:1371–1375
Demirol A, Gurgan T (2004) Effect of treatment of intrauterine pathologies with office hysteroscopy in patients with recurrent IVF failure. Reprod Biomed Online 8:590–594
Rama Raju GA, Shashi KG, Krishna KM, Prakash GJ, Madan K (2006) Assessment of uterine cavity by hysteroscopy in assisted reproduction programme and its influence on pregnancy outcome. Arch Gynecol Obstet 274:160–164
Singh N, Sumana G, Mittal S (2008) Genital tuberculosis: a leading cause for infertility in women seeking assisted conception in North India. Arch Gynecol Obstet 278(4):325
Wamsteker K, De Blok S (1993) Diagnostic hysteroscopy technique and documentation. In: Sutton C, Diamond M (eds) Endoscopic surgery for gynaecologists. Saunders, London, pp 263–276
Smit JG, Kasius JC, Eijkemans MJ, Koks CA, Van Golde R, Oosterhuis JG, Nap AW, Scheffer GJ, Manger PA (2012) The inSIGHT study: costs and effects of routine hysteroscopy prior to a first IVF treatment cycle. A randomised controlled trial. BMC Womens Health 8(12):22. doi:10.1186/1472-6874-12-22
Gera PS, Allemand MC, Tatpati LL, Galanits TM, Morbeck D, Coddington CC (2008) Role of saline infusion sonography in uterine evaluation before frozen embryo transfer cycle. Fertil Steril 89(3):562–566. doi:10.1016/j.fertnstert.2007.03.067
Rosa e Silva ACJS, Rosa e Silva JC, Reis FJC, Nogueira AA, Ferriani RA (2004) Routine office hysteroscopy in the investigation of infertile couples prior to assisted reproduction. Int Congr Ser 1271:255–258
Wang CW, Lee CL, Lai YM, Tsai CC, Chang MY, Soong YK (1996) Comparison of hysterosalpingography and hysteroscopy in female infertility. J Am Assoc Gynecol Laparosc 3(4):581–584
Sharma JB, Roy KK, Pushparaj M, Kumar S (2009) Hysteroscopic findings in women with primary and secondary infertility due to genital tuberculosis. Int J Gynaecol Obstet 104(1):49–52
Conflict of interest
The authors have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bahadur, A., Malhotra, N., Singh, N. et al. 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 288, 1137–1143 (2013). https://doi.org/10.1007/s00404-013-2842-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-013-2842-8