title: Diagnostic hysteroscopy: its value in an in-vitro fertilization/embryo transfer unit.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynaecology, Assaf Harofeh Medical Centre, Affiliated to Sackler School of Medicine, Tel Aviv University, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Golan
authors.forename: R
authors.initials: R
authors.lastname: Ron-El
authors.forename: A
authors.initials: A
authors.lastname: Herman
authors.forename: Y
authors.initials: Y
authors.lastname: Soffer
authors.forename: I
authors.initials: I
authors.lastname: Bukovsky
authors.forename: E
authors.initials: E
authors.lastname: Caspi
mesh_terms: D000328:Adult; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D015907:Hysteroscopy; D007247:Infertility, Female / Q000175:diagnosis* / Q000209:etiology; D012680:Sensitivity and Specificity; D000267:Tissue Adhesions / Q000150:complications / Q000175:diagnosis / Q000209:etiology; D014591:Uterine Diseases / Q000473:pathology; D014599:Uterus / Q000601:surgery*