Routine office hysteroscopy in the investigation of infertile couples prior to assisted reproduction

摘要

Objective: To evaluate the need foi office hysteroscopy in routine investigations of infertile couples prior to assisted reproduction (AR) Study design: A retrospective and descriptive clinical study of all outpatients submitted to AR technique infertility investigation from January 1996 to December 2001 in a tertiary medical center All of these patients underwent hysteroscopy Results: Within the group of 574 patients studied, 159 (27 7%) had no clinical complaints and presented normal ultrasounds. Of these 159 patients, only 8 (5%) presented abnormalities detected through hysteroscopy, and therefore would not have been diagnosed without the latter procedure Normal ultrasounds were seen in 498 (86,8%), 50 (8.7%) had abnormal hysteroscopies,. Only 29 (5,1%) of the 50 with abnormal hysteroscopies required treatment prior to AR No correlation was found between the two exam types (Kappa=0 305). Significant uterine cavity abnormalities were Mullerian malformations (in 30%), endometrial polyps (in 26.4%) and intrauterine adhesions (in 16%), Conclusion: Given the impracticality of performing hysteroscopy on pre-AR patients, we suggest that diagnostic hysteioscopy be considered only for patients whose clinical complaints imply the presence of endometrial disease or whose ultrasounds are abnormal.