Value of hysteroscopy in management of unexplained infertility

Elbareg, A.M.; Essadi, F.; Anwar, Kamal; Elmehashi, Mohamed O.

doi:10.1016/s2305-0500(14)60042-7

Cited by 10 publications

(9 citation statements)

References 27 publications

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“…Hysteroscopy is a reliable way to diagnose and treat uterine cavity anomalies like fibroids, polyps, septum and adhesions . Women with unexplained subfertility might benefit from hysteroscopic removal of submucous fibroids and polyps to improve their chances of conceiving .…”

Section: Investigations For Unexplained Subfertilitymentioning

confidence: 99%

“…64,65 Hysteroscopy Hysteroscopy is a reliable way to diagnose and treat uterine cavity anomalies like fibroids, polyps, septum and adhesions. 66 Women with unexplained subfertility might benefit from hysteroscopic removal of submucous fibroids and polyps to improve their chances of conceiving. 67 Where facilities are available, saline infusion sonography together with 3D ultrasound can offer a less invasive outpatient method to assess the uterine cavity with accuracy similar to that of hysteroscopy.…”

Section: Diagnostic Laparoscopymentioning

confidence: 99%

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Unexplained subfertility: diagnosis and management

Nandi

Homburg

2016

The Obstetric & Gynaecologis

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Key content Unexplained subfertility is diagnosed when standard investigations (tests for ovulation, tubal patency and semen analysis) are all normal. Between 30% and 40% of subfertile couples fall into this category. In some couples, unexplained subfertility may result from subtle undetectable factors; in other couples, it may be associated with a genuine absence of any abnormality. There is currently much controversy about the selection of appropriate management options for such couples, especially following the National Institute for Health and Care Excellence (NICE) guideline published in 2013. Therefore, a clear understanding of the available evidence is essential for the management of couples with unexplained subfertility. The potential contributing factors, diagnosis and management of unexplained subfertility are discussed. Learning objectives To summarise the available recent evidence and help the reader obtain a clear understanding of the continuing debates in this field. To help clinicians in counselling couples with unexplained subfertility. Ethical issues Should couples be advised to try to conceive naturally for 2 years (regardless of their age) before they are offered treatment, even though fecundity declines with age? What does the evidence suggest should be the first line of management for couples with unexplained subfertility: intrauterine insemination or in vitro fertilisation?

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Section: Investigations For Unexplained Subfertilitymentioning

confidence: 99%

Section: Diagnostic Laparoscopymentioning

confidence: 99%

Unexplained subfertility: diagnosis and management

Nandi

Homburg

2016

The Obstetric & Gynaecologis

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“…As a cause of unexplained infertility, subtle uterine abnormalities are diagnosed only during hysteroscopy and they are relatively common in infertility women. Although the presence of these abnormalities is not detected by the basic investigations for infertility, their correction seems to be necessary when infertility is desired and other infertility causes are excluded (Elbareg et al, 2014). Adrian et al, (2012) have expressed from their study that HSG is a safe, low cost and, with the application of propofol sedation, a well-tolerated procedure for tubal assessment, which should be performed at the end of the infertility investigation protocol.…”

Section: Resultsmentioning

confidence: 99%

Easing Infertility Problems Using Hysterosalpingography And Hysteroscopy In Al-Khoms Hospital, Libya

Osela¹

2016

IOSR

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“…Uterine abnormalities are estimated to play a causal role in a substantial number of couples seeking infertility treatment and in women with recurrent pregnancy losses [27,28,4,5]. Their assumed pathophysiological mechanism that they impair proper embryo implantation and growth due to poor vascularization with subsequent infertility or miscarriages [28].…”

Section: Discussionmentioning

confidence: 99%

“…Abnormal uterine findings are encountered in about 50% of women with reproductive failure. These high percentages of benign abnormalities are thought to be associated with poor endometrial receptivity affecting embryo implantation and necessitate proper evaluation of uterine cavity [1][2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Impact of routine hysteroscopy (HS) prior to intrauterine insemination (IUI) on pregnancy rates (PR) among infertile couples at Al-Amal Hospital, Misurata, Libya

Elbareg¹,

Essadi²

2017

J Pregnancy Reprod

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Objectives: To investigate the routine use of HS prior IUI in management of infertile women with main outcome measures studied was conception / PR. Materials and methods:Referred 180 patients, ages: 23-38 years with similar BMI and candidate for (COH) with IUI were included in a prospective controlled study for 2 years. Hormonal evaluation for all on day 3, divided into 2 groups; (A): underwent diagnostic HS to rule out intrauterine pathology (IUP), if found operated by HS before IUI, which has to be performed following cycle if normal or 2-3 cycles after operation. (B): Control (IUI without HS). Semen collected after 5 days of sexual abstinence, prepared by swim up technique, IUI performed with 0.5ml. Luteal support in all by oral dydrogestrone. Clinical PR: +ve pregnancy test and GS by (TVS) 4 weeks later & compared between the two gps. Any complications were recorded. Statistical analysis by using SPSS packages for Windows. P-value significant if (< 0.05).Results: out of 180 patients, 28/180 (15.5%) patients were lost in follow up: 18 from B group leaving 72/90 (80.0%), and 10 from A group, leaving 80/90 (88.8%). HS revealed no pathology in (58.8%), while (41.1%) were with abnormalities: (15.57%) mild adhesions, (8.86%) small endometrial polyps, (6.64%) small submucosal myomas, (4.46%) uterine septum, (3.34%) endocervical lesions, (2.21%) chronic non-specific endometritis, (abnormalities more in women aged ≥30 years and those with secondary infertility). No statistical difference in patient characteristics among groups. Pregnancy & pathology type relationship not significant (P > 0.623). Compared clinical PR in both gps after IUI was statistically significant (P< 0.05): 37/80 (46.25%) in HS group, and 18/80 (25%) in control group. All pregnancies in HS group occurred within first 2 IUI cycles. No significant reactions or surgical complications were recorded.Conclusions: HS before IUI is an effective and safe procedure in management of IUP, it improves significantly the chances of conception in infertile women before proceeding to more sophisticated and expensive treatment options.

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Value of hysteroscopy in management of unexplained infertility

Cited by 10 publications

References 27 publications

Unexplained subfertility: diagnosis and management

Unexplained subfertility: diagnosis and management

Easing Infertility Problems Using Hysterosalpingography And Hysteroscopy In Al-Khoms Hospital, Libya

Impact of routine hysteroscopy (HS) prior to intrauterine insemination (IUI) on pregnancy rates (PR) among infertile couples at Al-Amal Hospital, Misurata, Libya

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