Role of hysteroscopy prior to assisted reproduction techniques

Panagiotis Bakas, Dimitrios Hassiakos, Charalampos Grigoriadis, Nikolaos Vlahos, Angelos Liapis, Odysseas Gregoriou

Research output: Contribution to journalArticle

Abstract

Study Objective: To determine whether diagnostic hysteroscopy before assisted reproduction techniques (ΑRT) in women without known disease of the uterine cavity is necessary. Design: Prospective cohort clinical study. Setting: Reproductive medicine clinic. Patients: The study group consisted of 217 infertile women attending the Reproductive Clinic for examination before undergoing ART, either invitro fertilization or intracytoplasmic sperm injection. Interventions: Patients underwent transvaginal sonography (TVS) and hysterosalpingography (HSG) for initial evaluation. If there were no abnormal intrauterine findings, diagnostic hysteroscopy was additionally performed. Measurements and Main Results: The safety and diagnostic value of hysteroscopy before ART was examined. Diagnostic hysteroscopy was performed successfully, without complications, in all 217 women. Ninety-five (43.7%) had a history of ART failures (group 1), and 122 (56.3%) had undergone no previous ART attempts (group 2). In 148 women (68.2%), findings at hysteroscopy were normal, whereas in 69 (31.8%), hysteroscopy revealed intrauterine lesions (polyps, septa, submucosal leiomyomas, or synechiae) that led to operative hysteroscopy. The most common intrauterine abnormality was the presence of endometrial polyps in 26 patients (12%). The total percentage of abnormal intrauterine findings was higher in women with a history of repeated ART failures in comparison with those with no history of ART attempts. No statistically significant difference in the outcome of invitro fertilization or intracytoplasmic sperm injection was observed between women with normal hysteroscopic findings and patients with hysteroscopically corrected endometrial disease. Conclusion: Sensitivity of diagnostic hysteroscopy is significantly higher than TVS and HSG in the diagnosis of intrauterine lesions. Diagnostic hysteroscopy should be performed before ART in all patients, including women with normal TVS and/or HSG findings, because a significant percentage of them have undiagnosed uterine disease that may impair the success of fertility treatment.

Original languageEnglish (US)
Pages (from-to)233-237
Number of pages5
JournalJournal of Minimally Invasive Gynecology
Volume21
Issue number2
DOIs
StatePublished - Mar 2014
Externally publishedYes

Fingerprint

Reproductive Techniques
Hysteroscopy
Uterine Diseases
Hysterosalpingography
Ultrasonography
Intracytoplasmic Sperm Injections
Polyps
Fertilization
Reproductive Medicine
Leiomyoma
Prenatal Diagnosis
Fertility
Cohort Studies
Safety

Keywords

  • Assisted reproduction techniques
  • Hysterosalpingography
  • Hysteroscopy
  • Infertility
  • Intracytoplasmic sperm injection
  • Invitro fertilization

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Medicine(all)

Cite this

Bakas, P., Hassiakos, D., Grigoriadis, C., Vlahos, N., Liapis, A., & Gregoriou, O. (2014). Role of hysteroscopy prior to assisted reproduction techniques. Journal of Minimally Invasive Gynecology, 21(2), 233-237. https://doi.org/10.1016/j.jmig.2013.07.023

Role of hysteroscopy prior to assisted reproduction techniques. / Bakas, Panagiotis; Hassiakos, Dimitrios; Grigoriadis, Charalampos; Vlahos, Nikolaos; Liapis, Angelos; Gregoriou, Odysseas.

In: Journal of Minimally Invasive Gynecology, Vol. 21, No. 2, 03.2014, p. 233-237.

Research output: Contribution to journalArticle

Bakas, P, Hassiakos, D, Grigoriadis, C, Vlahos, N, Liapis, A & Gregoriou, O 2014, 'Role of hysteroscopy prior to assisted reproduction techniques', Journal of Minimally Invasive Gynecology, vol. 21, no. 2, pp. 233-237. https://doi.org/10.1016/j.jmig.2013.07.023
Bakas P, Hassiakos D, Grigoriadis C, Vlahos N, Liapis A, Gregoriou O. Role of hysteroscopy prior to assisted reproduction techniques. Journal of Minimally Invasive Gynecology. 2014 Mar;21(2):233-237. https://doi.org/10.1016/j.jmig.2013.07.023
Bakas, Panagiotis ; Hassiakos, Dimitrios ; Grigoriadis, Charalampos ; Vlahos, Nikolaos ; Liapis, Angelos ; Gregoriou, Odysseas. / Role of hysteroscopy prior to assisted reproduction techniques. In: Journal of Minimally Invasive Gynecology. 2014 ; Vol. 21, No. 2. pp. 233-237.
@article{63617496505a40aabc0bd261d3086902,
title = "Role of hysteroscopy prior to assisted reproduction techniques",
abstract = "Study Objective: To determine whether diagnostic hysteroscopy before assisted reproduction techniques (ΑRT) in women without known disease of the uterine cavity is necessary. Design: Prospective cohort clinical study. Setting: Reproductive medicine clinic. Patients: The study group consisted of 217 infertile women attending the Reproductive Clinic for examination before undergoing ART, either invitro fertilization or intracytoplasmic sperm injection. Interventions: Patients underwent transvaginal sonography (TVS) and hysterosalpingography (HSG) for initial evaluation. If there were no abnormal intrauterine findings, diagnostic hysteroscopy was additionally performed. Measurements and Main Results: The safety and diagnostic value of hysteroscopy before ART was examined. Diagnostic hysteroscopy was performed successfully, without complications, in all 217 women. Ninety-five (43.7{\%}) had a history of ART failures (group 1), and 122 (56.3{\%}) had undergone no previous ART attempts (group 2). In 148 women (68.2{\%}), findings at hysteroscopy were normal, whereas in 69 (31.8{\%}), hysteroscopy revealed intrauterine lesions (polyps, septa, submucosal leiomyomas, or synechiae) that led to operative hysteroscopy. The most common intrauterine abnormality was the presence of endometrial polyps in 26 patients (12{\%}). The total percentage of abnormal intrauterine findings was higher in women with a history of repeated ART failures in comparison with those with no history of ART attempts. No statistically significant difference in the outcome of invitro fertilization or intracytoplasmic sperm injection was observed between women with normal hysteroscopic findings and patients with hysteroscopically corrected endometrial disease. Conclusion: Sensitivity of diagnostic hysteroscopy is significantly higher than TVS and HSG in the diagnosis of intrauterine lesions. Diagnostic hysteroscopy should be performed before ART in all patients, including women with normal TVS and/or HSG findings, because a significant percentage of them have undiagnosed uterine disease that may impair the success of fertility treatment.",
keywords = "Assisted reproduction techniques, Hysterosalpingography, Hysteroscopy, Infertility, Intracytoplasmic sperm injection, Invitro fertilization",
author = "Panagiotis Bakas and Dimitrios Hassiakos and Charalampos Grigoriadis and Nikolaos Vlahos and Angelos Liapis and Odysseas Gregoriou",
year = "2014",
month = "3",
doi = "10.1016/j.jmig.2013.07.023",
language = "English (US)",
volume = "21",
pages = "233--237",
journal = "Journal of Minimally Invasive Gynecology",
issn = "1553-4650",
publisher = "Elsevier",
number = "2",

}

TY - JOUR

T1 - Role of hysteroscopy prior to assisted reproduction techniques

AU - Bakas, Panagiotis

AU - Hassiakos, Dimitrios

AU - Grigoriadis, Charalampos

AU - Vlahos, Nikolaos

AU - Liapis, Angelos

AU - Gregoriou, Odysseas

PY - 2014/3

Y1 - 2014/3

N2 - Study Objective: To determine whether diagnostic hysteroscopy before assisted reproduction techniques (ΑRT) in women without known disease of the uterine cavity is necessary. Design: Prospective cohort clinical study. Setting: Reproductive medicine clinic. Patients: The study group consisted of 217 infertile women attending the Reproductive Clinic for examination before undergoing ART, either invitro fertilization or intracytoplasmic sperm injection. Interventions: Patients underwent transvaginal sonography (TVS) and hysterosalpingography (HSG) for initial evaluation. If there were no abnormal intrauterine findings, diagnostic hysteroscopy was additionally performed. Measurements and Main Results: The safety and diagnostic value of hysteroscopy before ART was examined. Diagnostic hysteroscopy was performed successfully, without complications, in all 217 women. Ninety-five (43.7%) had a history of ART failures (group 1), and 122 (56.3%) had undergone no previous ART attempts (group 2). In 148 women (68.2%), findings at hysteroscopy were normal, whereas in 69 (31.8%), hysteroscopy revealed intrauterine lesions (polyps, septa, submucosal leiomyomas, or synechiae) that led to operative hysteroscopy. The most common intrauterine abnormality was the presence of endometrial polyps in 26 patients (12%). The total percentage of abnormal intrauterine findings was higher in women with a history of repeated ART failures in comparison with those with no history of ART attempts. No statistically significant difference in the outcome of invitro fertilization or intracytoplasmic sperm injection was observed between women with normal hysteroscopic findings and patients with hysteroscopically corrected endometrial disease. Conclusion: Sensitivity of diagnostic hysteroscopy is significantly higher than TVS and HSG in the diagnosis of intrauterine lesions. Diagnostic hysteroscopy should be performed before ART in all patients, including women with normal TVS and/or HSG findings, because a significant percentage of them have undiagnosed uterine disease that may impair the success of fertility treatment.

AB - Study Objective: To determine whether diagnostic hysteroscopy before assisted reproduction techniques (ΑRT) in women without known disease of the uterine cavity is necessary. Design: Prospective cohort clinical study. Setting: Reproductive medicine clinic. Patients: The study group consisted of 217 infertile women attending the Reproductive Clinic for examination before undergoing ART, either invitro fertilization or intracytoplasmic sperm injection. Interventions: Patients underwent transvaginal sonography (TVS) and hysterosalpingography (HSG) for initial evaluation. If there were no abnormal intrauterine findings, diagnostic hysteroscopy was additionally performed. Measurements and Main Results: The safety and diagnostic value of hysteroscopy before ART was examined. Diagnostic hysteroscopy was performed successfully, without complications, in all 217 women. Ninety-five (43.7%) had a history of ART failures (group 1), and 122 (56.3%) had undergone no previous ART attempts (group 2). In 148 women (68.2%), findings at hysteroscopy were normal, whereas in 69 (31.8%), hysteroscopy revealed intrauterine lesions (polyps, septa, submucosal leiomyomas, or synechiae) that led to operative hysteroscopy. The most common intrauterine abnormality was the presence of endometrial polyps in 26 patients (12%). The total percentage of abnormal intrauterine findings was higher in women with a history of repeated ART failures in comparison with those with no history of ART attempts. No statistically significant difference in the outcome of invitro fertilization or intracytoplasmic sperm injection was observed between women with normal hysteroscopic findings and patients with hysteroscopically corrected endometrial disease. Conclusion: Sensitivity of diagnostic hysteroscopy is significantly higher than TVS and HSG in the diagnosis of intrauterine lesions. Diagnostic hysteroscopy should be performed before ART in all patients, including women with normal TVS and/or HSG findings, because a significant percentage of them have undiagnosed uterine disease that may impair the success of fertility treatment.

KW - Assisted reproduction techniques

KW - Hysterosalpingography

KW - Hysteroscopy

KW - Infertility

KW - Intracytoplasmic sperm injection

KW - Invitro fertilization

UR - http://www.scopus.com/inward/record.url?scp=84896737973&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84896737973&partnerID=8YFLogxK

U2 - 10.1016/j.jmig.2013.07.023

DO - 10.1016/j.jmig.2013.07.023

M3 - Article

VL - 21

SP - 233

EP - 237

JO - Journal of Minimally Invasive Gynecology

JF - Journal of Minimally Invasive Gynecology

SN - 1553-4650

IS - 2

ER -