Office Hysteroscopy in Infertility

Background: For patients undergoing in vitro fertilization, lower pregnancy rates are observed in the presence of uterine cavity anomalies and correction of these anomalies has been associated with improved pregnancy rates. Office hysteroscopy has been proven to have superior sensitivity and specificity in evaluation of the endometrial cavity. Diagnostic hysteroscopy can be performed in an office with minimal discomfort and at a much lower cost than in an operating room. Our study was done to evaluate the importance of office hysteroscopy in diagnosis of pathology in normal appearing infertility work up. Materials and Methods: This study was performed from September 1, 2006 till September 1, 2008 at Imam Khomayni hospital, Ahwaz, Iran. All infertile patients who had unexplained infertility or uterine factor infertility were enrolled in the study and underwent office hysteroscopy. The participants were divided into two groups. Group one was composed of 54 patients with unexplained infertility and group two was composed of 53 patients with abnormal vaginal sonography or hysterosalpangography. Results: Of the 54 patients with unexplained infertility; 33 patients (61.2%) had normal and 21 patients (38.8%) had abnormal hysteroscopic findings. Among 53 patients in the uterine factor group, there were 7 women (13.3%) who had a normal hysteroscopy and abnormal sonography or hysterography. Conclusion: In group one (unexplained infertility), there was a 38.8% positive finding in office hysteroscopy in spite of normal hysterosalpingography and sonography results. Therefore, it seems that office hysteroscopy should be a part of a routine work up in infertile patients.