%0 Journal Article
%T Office Hysteroscopy for Infertility: A Series of 557 Consecutive Cases
%A Martin Koskas
%A Jean-Luc Mergui
%A Chadi Yazbeck
%A Serge Uzan
%A Jacky Nizard
%J Obstetrics and Gynecology International
%D 2010
%I Hindawi Publishing Corporation
%R 10.1155/2010/168096
%X Objective. To study incidence of abnormal hysteroscopic findings according to age. Methods. We retrospectively studied 557 consecutive office hysteroscopies in patients referred for incapacity to conceive lasting at least 1 year or prior to in vitro fertilization. Rates of abnormal findings were reviewed according to age. Results. In 219 cases, hysteroscopy showed an abnormality and more than a third of our population had abnormal findings that could be related to infertility. Rates of abnormal findings ranged from 30% at 30 years to more than 60% after 42 years. Risk of abnormal finding was multiplied by a factor of 1.5 every 5 years. Conclusion. Our data are an additional argument to propose office hysteroscopy as part of first-line exams in infertile woman, regardless of age. 1. Introduction Hysteroscopy is the gold standard procedure for uterine cavity exploration [1]. However, the World Health Organization (WHO) recommends hysterosalpingography (HSG) alone for management of infertile women [2]. The explanation for this discrepancy is that HSG provides information on tubal patency or blockage. Office hysteroscopy is only recommended by the WHO when clinical or complementary exams (ultrasound, HSG) suggest intrauterine abnormality [3] or after in vitro fertilization (IVF) failure [4]. Nevertheless, many specialists feel that hysteroscopy is a more accurate tool because of the high false-positive and falsenegative rates of intra uterine abnormality with HSG [1, 5, 6]. This explains why many specialists use hysteroscopy as a first-line routine exam for infertility patients regardless of guidelines. The aim of this retrospective study is to describe hysteroscopy findings in a population of 557 infertile patients. 2. Materials and Methods We analyzed retrospectively 557 patients referred for hysteroscopy for incapacity to conceive lasting at least 1 year or prior to IVF, from November 2002 to July 2006. This population represents one third of hysteroscopies on that period. All hysteroscopies were performed by the same operator (JLM). Procedures lasted approximately two minutes without anesthesia or cervical preparation in an office gynecology setting. Diagnostic video-assisted hysteroscopy was performed using a flexible hysteroscope (flexible hysteroscope, Olympus HYF-P, Paris, France) with an outer diameter of 3.1£żmm. Procedures were not video recorded. The uterine cavity was expanded under manual hydrostatic pressure (saline solution). Hysteroscopy was performed with a standard sequence, inspecting the endocervical canal, uterine cavity, endometrium,
%U http://www.hindawi.com/journals/ogi/2010/168096/