Routine office hysteroscopy in the investigation of infertile couples before assisted reproduction (original) (raw)

Objective: To evaluate the need for 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 Mqllerian 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 hysteroscopy be considered only for patients whose clinical complaints imply the presence of endometrial disease or whose ultrasounds are abnormal. D