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The Hysteroscope and Infertility

10 April, 2013 | Obstetrics & Gynecology

Hysteroscope

Hysteroscope

The hysteroscope is used for diagnosis and treatment of uterus problems. The first hysteroscope was created in 1865 and was first used for gynecology in 1869. The device went through a certain technological revolution in the 1970’s, and additional advances in recent years have decreased its use in diagnosis and increased its use in treatment. Approximately half the time that the hysteroscope is used is infertility related.

 Reviewing the hysteroscope in infertility treatment

 It is assumed that endometrial polyps in the uterine cavity may be problematic in the implantation process of a fertilized egg, accordingly, it has been suggested that removal of these polyps may help increase chances for pregnancy, whether naturally or in fertility treatment.

The Cochrane Database of Systematic Reviews turned to existing studies to examine this issue; they reviewed studies that discussed whether hysteroscopic treatment, such as removal of polyps and the treatment of several additional disorders, increases pregnancy chances in women with unexplained infertility and before artificial insemination.

The conclusions from two studies, that were found to be relevant, provided no evidence that the treatment aided in natural conception, however the removal of the polyps before intrauterine insemination (IUI) did increase the chance for pregnancy. For IUI the percentage of women who became pregnant following hysteroscopic polyp removal was 63% in relation to a 28% pregnancy rate in women for whom only a diagnosis and biopsy were conducted using hysteroscopy.

The review claimed that additional studies were necessary for confirmation of these results and before recommending the procedure as fertility enhancing. The reviewers additionally noted that complications of hysteroscopy and live birth rates were not reported in the study.

 Conclusion

In conclusion, it can be said that there is a certain amount of evidence to support the premise that hysteroscopic treatment for polyp removal may increase the chance for pregnancy via IUI, but does not seem to make a difference in natural conception. In addition, this positive contribution is especially evident when the hysteroscope is used for treatment and is considerably lower when it is used only as a diagnostic tool.