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.

Keywords: endometrial pathology, in-vitro fertilization, office-based hysteroscopy