How often does office hysteroscopy reveal pathology not previously noted on transvaginal ultrasound—a look at two typical reproductive endocrinology patient groups, including failed IVF–ET patients

摘要

Transvaginal ultrasound and office hysteroscopy are established diagnostic tools for the evaluation of infertility patients, with hysteroscopy often considered as the more precise method to evaluate the uterine cavity and ultrasound as the more readily available and less invasive method. We look at both methods in two typical infertility patient groups, including one group with a history of failed in vitro fertilization–embryo transfer (IVF–ET) cycles. Eighty patients were prospectively evaluated. Forty patients presented with a history of failed embryo transfer despite repeat normal transvaginal ultrasound examinations. Forty infertility patients with abnormal ultrasound testing served as a group for comparison. All patients underwent office hysteroscopy. In the subgroup with abnormal ultrasound findings, office hysteroscopy confirmed the diagnosis in 75% of cases but did not add new information. In patients with a history of failed embryo transfer and at least twice normal ultrasound examinations, only 1/40 patients (2.5%) was noted to have a minor abnormality on office hysteroscopy not previously diagnosed on ultrasound. In infertility patients, including those with a history of failed IVF–ET cycles, repeat normal transvaginal ultrasound appears to be an efficient method for the determination of significant intrauterine abnormalities.