title: Transcervical placement of a Malecot catheter after hysteroscopic evaluation provides for easier entry into the endometrial cavity for women with histories of difficult intrauterine inseminations and/or embryo transfers: a prospective case series.
abstract: OBJECTIVE
  To evaluate a new technique designed to improve access to the endometrial cavity through tortuous and/or stenotic endocervical canals in women with histories of difficult IUIs, ETs, or endometrial biopsies.
  
  
  METHODS
  Prospective case series.
  
  
  METHODS
  Tertiary care center.
  
  
  METHODS
  Women with histories of difficult intrauterine procedures because of tortuous and/or stenotic endocervical canals who continued to undergo treatment.
  
  
  METHODS
  Hysteroscopic evaluation and/or correction of the endocervix, followed by transcervical placement of a Malecot catheter (CR Bard Inc., Covington, GA) for an average of 10 days.
  
  
  METHODS
  Improvement in the ease of access to the endometrial cavity during IUIs or ETs.
  
  
  RESULTS
  Thirty-two of 36 patients had significantly easier procedures after the placement and removal of a Malecot catheter.
  
  
  CONCLUSIONS
  Hysteroscopic evaluation and placement of a Malecot catheter is a useful technique that allows easier entry through the cervical canal in patients in whom previous IUIs, ETs, and endometrial biopsies have been difficult. This procedure may lead to improved pregnancy rates, particularly with IVF-ET, as the ease of ET has been correlated with improved implantation rates.
authors.affiliation: Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
authors.forename: E H
authors.initials: EH
authors.lastname: Yanushpolsky
authors.forename: E S
authors.initials: ES
authors.lastname: Ginsburg
authors.forename: J H
authors.initials: JH
authors.lastname: Fox
authors.forename: E A
authors.initials: EA
authors.lastname: Stewart
mesh_terms: D000328:Adult; D002404:Catheterization / Q000295:instrumentation* / Q000379:methods*; D002584:Cervix Uteri / Q000033:anatomy & histology / Q000473:pathology; D003251:Constriction, Pathologic; D004624:Embryo Transfer / Q000379:methods*; D004717:Endometrium; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D015907:Hysteroscopy; D007315:Insemination, Artificial / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D016896:Treatment Outcome