Diagnostic hysteroscopy: its value in an in-vitro fertilization/embryo transfer unit.
A total of 324 patients participating in our in-vitro fertilization/embryo transfer ( IVF) programme underwent a diagnostic hysteroscopy. Of these, 152 women were referred before their first IVF attempt, because of some hysterosalpingographic suspicion of an intra-uterine abnormality; the other 172 patients had failed to conceive after IVF and transfer of good quality embryos. An intra-uterine pathology (mainly intra-uterine adhesions) was diagnosed in 50% of the patients in each group. Hysterosalpingography, although very sensitive, had low specificity (23%), a false positive rate of 44% and false negative rate of 10%. The main risk factor for intra-uterine pathology was a previous abortion. Conception rates were 22% after surgical treatment and 38% after the diagnostic procedure. We think that hysteroscopy should be performed in every patient failing to conceive after replacement of good quality embryos. It is also recommended whenever a suspicious finding is revealed by hysterosalpingography, before IVF. Routine hysteroscopy before entering an IVF programme should be seriously considered.[1]References
- Diagnostic hysteroscopy: its value in an in-vitro fertilization/embryo transfer unit. Golan, A., Ron-El, R., Herman, A., Soffer, Y., Bukovsky, I., Caspi, E. Hum. Reprod. (1992) [Pubmed]
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