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Diagnostic Office Vaginohysteroscopy in Evaluation of Infertility Prior to IVF: A Retrospective Analysis of 1000 Cases

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Abstract

Aim

The aim of this study was to analyze the utility of routine use of diagnostic office vaginohysteroscopy in the evaluation of uterine cavity in infertility patients prior to IVF-ET.

Materials and Methods

We conducted a retrospective analysis of 1000 women who had undergone routine diagnostic office vaginohysteroscopy as an institutional protocol in the evaluation of infertility prior to IVF-ET cycle at a tertiary care hospital. They were divided into two groups: primary infertility (group I) and secondary infertility (group II). The primary outcome was the finding of an abnormal uterine cavity (congenital abnormality vs acquired abnormality).

Results

One thousand women underwent routine diagnostic office vaginohysteroscopy in the evaluation of infertility prior to IVF-ET. There were no intraoperative or postoperative complications. Vaginohysteroscopy revealed an abnormal uterine cavity in 13.8% (1000 patients) of women. Primary infertility group (I) had 13.19% (811 patients), and secondary infertility group (II) had 16.4% (189 patients) abnormal uterine cavities.

Conclusion

Diagnostic office vaginohysteroscopy has a definite role in the uterine cavity evaluation in infertility patients prior to IVF, but routine use should not be recommended considering the low incidence of abnormal uterine cavity findings. Moreover, the majority of these uterine cavity abnormalities can be detected by less invasive tests such as HSG, TVS, SSG and 3D ultrasound.

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References

  1. El-Mazny A, Abou-Salem N, El-Sherbiny W, et al. Outpatient hysteroscopy: a routine investigation before assisted reproductive techniques? Fertil Steril. 2011;95(1):272–6.

    Article  PubMed  Google Scholar 

  2. El Huseiny AM, Soliman BS. Hysteroscopic findings in infertile women: a retrospective study. Middle East Fertil Soc J. 2013;18(3):154–8.

    Article  Google Scholar 

  3. Stefanescu A, Marinescu B. Diagnostic hysteroscopy: a retrospective study of 1545 cases. Maedica (Buchar). 2012;7(4):309–14.

    PubMed  PubMed Central  Google Scholar 

  4. Mohammadi SS, Abdi M, Movafegh A. Comparing transcervical intrauterine lidocaine instillation with rectal diclofenac for pain relief during outpatient hysteroscopy: a randomized controlled trial. Oman Med J. 2015;30(3):157–61.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Darwish AM. Routine vaginoscopic office hysteroscopy in modern infertility work up. Fertil Steril. 2013;100(3):S395.

    Article  Google Scholar 

  6. Shawki HE, Elmorsy M, Eissa MK. Routine office hysteroscopy prior to ICSI and its impact on assisted reproduction program outcome: a randomized controlled trial. Middle East Fertil Soc J. 2012;17(1):14–21.

    Article  Google Scholar 

  7. Ludwin A, Ludwin I. Comparison of the ESHRE–ESGE and ASRM classifications of Mullerian duct anomalies. Hum Reprod. 2015;30(3):569–80.

    Article  CAS  PubMed  Google Scholar 

  8. Grimbizis GF, Campo R. Clinical approach for the classification of congenital uterine malformations. Gynecol Surg. 2012;9(2):119–29.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Darwish AM, Hassanin AI, Mohammad II, et al. Routine vaginoscopic office hysteroscopy in modern infertility work up: a randomized controlled trial. Gynecol Surg. 2014;11(3):185–9.

    Article  Google Scholar 

  10. Sahu L, Tempe A, Gupta S. Hysteroscopic evaluation in infertile patients: a prospective study. Int J Reprod Contracept Obstet Gynecol. 2012;1(1):37–41.

    Article  Google Scholar 

  11. Siam S. Role of office hysteroscopy in the evaluation of infertile women after controlled ovarian stimulation/intra uterine insemination failure. Middle East Fertil Soc J. 2014;19(4):239–42.

    Article  Google Scholar 

  12. Venetis CA, Papadopoulos SP, Campo R, et al. Clinical implications of congenital uterine anomalies: a meta-analysis of comparative studies. Reprod Biomed. 2014;29(6):665–83.

    Article  Google Scholar 

  13. Floss K, Garcia-Rocha G-J, Kundu S, et al. Fertility and pregnancy outcome after myoma enucleation by minilaparotomy under microsurgical conditions in pronounced uterus myomatosus. Geburtshilfe Frauenheilkd. 2015;75(1):56–63.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Munro MG, Critchley HO, Fraser IS. Group FMDW the FIGO classification of causes of abnormal uterine bleeding in the reproductive years. Fertil Steril. 2011;95(7):2204–8.

    Article  PubMed  Google Scholar 

  15. Sanoee MF, Alizamir T, Faramarzi S, et al. Effect of myomectomy on endometrial glutathione peroxidase 3 (GPx3) and glycodelin mRNA expression at the time of the implantation window. Iran Biomed J. 2014;18(2):60–6.

    CAS  Google Scholar 

  16. Zayed M, Fouda UM, Zayed SM, et al. Hysteroscopic myomectomy of large submucous myomas in a 1-step procedure using multiple slicing sessions technique. J Minim Invasive Gynecol. 2015;22(7):1196–202.

    Article  PubMed  Google Scholar 

  17. Jayakrishnan K, Menon V, Nambiar D. Submucous fibroids and infertility: effect of hysteroscopic myomectomy and factors influencing outcome. J Hum Reprod Sci. 2013;6(1):35–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Pereira N, Amrane S, Estes JL, et al. Does the time interval between hysteroscopic polypectomy and start of IVF affect outcomes? Fertil Steril. 2016;105(2):539–44.

    Article  PubMed  Google Scholar 

  19. American Association of Gynecologic Laparoscopists. AAGL practice report: practice guidelines for the diagnosis and management of endometrial polyps. J Minimally Invasive Gynecol. 2012;19(1):3–10.

    Article  Google Scholar 

  20. Rackow BW, Jorgensen E, Taylor HS. Endometrial polyps affect uterine receptivity. Fertil Steril. 2011;95(8):2690–2.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Malhotra N, Bahadur A, Kalaivani M, et al. Changes in endometrial receptivity in women with Asherman’s syndrome undergoing hysteroscopic adhesiolysis. Arch Gynecol Obstet. 2012;286(2):525–30.

    Article  PubMed  Google Scholar 

  22. Conforti A, Alviggi C, Mollo A, et al. The Management of Asherman syndrome: a review of literature. Reprod Biol Endocrinol. 2013;11:118.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Hua Y, Zhang W, Hu X, et al. The use of misoprostol for cervical priming prior to hysteroscopy: a systematic review and analysis. Drug Des Devel Ther. 2016;10:2789–801.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Bastu E, Celik C, Nehir A, et al. Cervical priming before diagnostic operative hysteroscopy in infertile women: a randomized, double-blind, controlled comparison of 2 vaginal Misoprostol Doses. Int Surg. 2013;98(2):140–4.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Bingol B, Gunenc MZ, Gedikbasi A, et al. Comparison of diagnostic accuracy of saline infusion sonohysterography, transvaginalsonography and hysteroscopy in postmenopausal bleeding. Arch Gynecol Obstet. 2011;284:111–7.

    Article  PubMed  Google Scholar 

  26. Ahmadi F, Rashidy Z, Haghighi H, et al. Uterine cavity assessment in infertile women: Sensitivity and specificity of three- dimensional hysterosonography versus hysteroscopy. Iran J Reprod Med. 2013;11(12):977–82.

    PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

Authors

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Correspondence to Praveen Kumar.

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Conflict of interest

There is no potential conflict of interest for any author.

Ethical Standards

Since this study is a retrospective analysis of diagnostic office vaginohysteroscopies performed in a tertiary care center as an institutional protocol in the evaluation of infertility patients prior to IVF, no ethical issues are involved.

Informed Consent

Written informed consent was taken from each patient in the study.

Additional information

Dr. Praveen Kumar is a Gynae Endoscopic Surgeon and Senior Fellow Reproductive Medicine at ART Centre, Army Hospital (Research & Referral), Delhi.

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Kumar, P., Mohan, S., Talwar, P. et al. Diagnostic Office Vaginohysteroscopy in Evaluation of Infertility Prior to IVF: A Retrospective Analysis of 1000 Cases. J Obstet Gynecol India 67, 275–281 (2017). https://doi.org/10.1007/s13224-017-0972-9

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  • DOI: https://doi.org/10.1007/s13224-017-0972-9

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