Abnormal activation of endometrial innate immunity by means of inflammosome, stimulated by pathogen- or damage-associated molecular patterns, may represent an additional mechanism, currently not investigated, negatively interfering with endometrial receptivity. More studies are required [1] to identify the primary trigger of endometrial inflammosome activation and its clinical impact in the occurrence of RPL; and [2] to validate the inflammosome components as a novel family of endometrial biomarkers and promising therapeutic targets in RPL.

HSG is of exclusive importance in the assessment of tubal morphology and function and has a secondary and complementary role to HSC in the inspection of the uterine cavity and tubal ostia.

Our result suggests that the hysteroscope size plays a pivotal role in the acceptance and for the success of office hysteroscopy.

Objective The aim is to stress the fundamental role of hysteroscopy in the diagnosis of the cause of endometrial pathologies. Subjects and methods The results of 10 years’ experience, between December 1984 and January 1995, in the gynaecological endoscopy outpatients' unit of the Catholic University of Rome are reported. A series of 6180 women undergoing diagnostic hysteroscopy is analysed and the indications, contraindications and side‐effects of hysteroscopic examination are discussed. Results Outpatients, mean age of 51 years (range 22–81), who underwent hysteroscopic examination had, as main indication, abnormal uterine bleeding (AUB). The differing distributions of hysteroscopic findings in pre‐ and postmenopausal women is stressed, along with the importance of focal endometrial pathologies such as polyps and submucosal myomas in premenopause, the high incidence of endometrial atrophy, and the significant occurrence of hyperplastic and neoplastic hysteroscopic findings in the postmenopause. Primary and secondary infertility are, after AUB, the second most common indications for hysteroscopic examination, and the role of malformation (septate and subseptate uterus), inflammation (intrauterine synechiae) and focal endometrial pathologies (polyps and submucosal myomas) is illustrated. Conclusions As a result of the introduction of hysteroscopy it is now possible to preserve organs, with the slight trauma of noninvasive treatment, rather than using extirpartive surgery. In premenopausal women with AUB (n=2132) the most frequent pathologies were low‐risk hyperlasia (25.3%), submucosal myoma (24.5%) and endometrial polyps (8.3%); there were normal findings in 40.2%. There is a low incidence of high‐risk hyperplasia (0.7%) and neoplastic pathology (0.5%). In postmenopausal women with AUB there is a high incidence of atrophy (23%), whereas high‐risk hyperplasia and neoplastic pathology are five and eight times more common, respectively, in these women than in premenopausal patients.

The results of the current study support the recommendation not to prescribe routine antibiotic prophylaxis prior to operative hysteroscopy.

Uterine artery embolization (UAE) is still regarded by most gynaecologists as contraindicated for women with symptomatic fibroids and otherwise unexplained infertility. For such patients, myomectomy is the usual option. We performed UAE as treatment of menorrhagia in an infertile woman with multiple subserosal and intramural fibroids who had previously failed multiple myomectomy. UAE resulted in durable symptom relief and substantial reduction of the uterine and fibroid size. The patient conceived spontaneously 20 months after UAE and progressed through pregnancy uneventfully. At 38 weeks of gestation, she underwent elective cesarean section and delivered a normal, healthy, 3180-g fetus without complications. The present case demonstrates that in symptomatic women with multiple subserosal and intramural fibroids and otherwise unexplained infertility, UAE may have symptomatic and reproductive outcomes superior to those of myomectomy.