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Role of hysteroscopy and endometrial biopsy in women with unexplained infertility

  • Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objectives

This study was designed to evaluate the role of hysteroscopy and endometrial biopsy in women with unexplained infertility.

Patients and methods

Women with unexplained infertility were included in this prospective study, evaluated with transvaginal sonography and diagnostic hysteroscopy. Diagnostic hysteroscopy was performed between the 7th and 11th day of the cycle. The criteria for hysteroscopic findings were based on the cervical canal, uterine cavity, endometrium, visualization of the ostium tubae and lesions of the utero-tubal junction. After the hysteroscopic examination, endometrial biopsy was performed using a Pipelle® endometrial suction curette. Patients were classified according to the hysteroscopy results into four groups: patients with no abnormality detected (14), patients with cervical abnormalities (six), patients with endometrial abnormalities (73) and patients with uterine abnormalities (seven).

Results

One hundred women with unexplained infertility were included. All patients underwent diagnostic hysteroscopy, except for seven patients: six patients had stenotic external or internal cervical ostium and one had inadequate visualization as the uterine cavity was filled with blood. Based on hysteroscopic findings, 31 patients were finally diagnosed with endometrial polyps; 14 endometritis; 15 endometrial hyperplasia; six submucous myomas; seven intrauterine synechiae (73 cases = endometrial abnormalities group); seven congenital uterine anomalies (uterine abnormalities group), six cervical stenosis (cervical abnormalities group) and 14 women without any uterine abnormalities (no abnormalities group). Analysis of samples obtained using the Pipelle® endometrial suction curette was non-diagnostic in 16 cases; the most common endometrial pathological feature detected by this analysis was endometritis (15 %).

Conclusions

Routine hysteroscopy and endometrial biopsy should be used as a basic part of the work-up for women with unexplained infertility.

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Abbreviations

E2:

Estradiol

EB:

Endometrial biopsy

ET:

Embryo transfer

HSG:

Hysterosalpingography

IVF:

In vitro fertilization

TVS:

Transvaginal sonography

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Abbasia, Cairo, Egypt

    Ahmed Khairy Makled, Mohamed Mahmoud Farghali & Demiana Samir Shenouda

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  1. Ahmed Khairy Makled
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  2. Mohamed Mahmoud Farghali
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  3. Demiana Samir Shenouda
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Correspondence to Ahmed Khairy Makled.

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Makled, A.K., Farghali, M.M. & Shenouda, D.S. Role of hysteroscopy and endometrial biopsy in women with unexplained infertility. Arch Gynecol Obstet 289, 187–192 (2014). https://doi.org/10.1007/s00404-013-2931-8

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  • DOI: https://doi.org/10.1007/s00404-013-2931-8

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