Hysteroscopy In Infertile Patients with Suspected Intrauterine Lesions : A Results Of 143 Patients At Ramathibodi Hospital

Abstract

Objective To report our initial experience and results of hysteroscopic examinations in infertile patients with suspected intrauterine lesions.

Main outcome measures Number and percentage of hysteroscopic findings.

Results Hysteroscopic examination was satisfactory in all 143 patients. The indica tions for diagnostic hysteroscopy and hysteroscopic findings in the 143 patients were abnormal hysterosalpingographies (HSGs) with suspected Intrauterine adhesions (IUAs) in 39, secondary amenorrhea with suspected IUAs in 12, abnormal HSGs with suspected endometrial polyps in 21, abnormal HSGs with suspected submuco-usmyomas in 20, suspected endometrial polyps by transvaginal U/S in 11, suspected submucous myomas transvaginal U/S in 5, infertility with abnormal uterine bleeding (AUB) in 12, failed many attempts with IVF in 12, abnormal HSGs with suspected mullerian defects in 6, and unexplained infertility in 5 patients. Of the 143 patients, 113 (79.02%) showed some abnor malities of the uterine cavity on hysteroscopy. In thirty patients (20.98%) the hysteroscopy demonstrated normal uterine cavities. The detected abnormalities were 41 (28.67%) intrauterine adhesions, 9 (6.29%) cervical stenosises, 41 (28.67%) endometrial polyps, 14 (9.79%) submucous myomas, 6 (4.20%) mullerian defects, 2 (1.40%) endometrial hyperplasia. Intrauterine abnormalities were shown on HSG in 86 patients and confirmed in 51 patients at hysteroscopy giving an accuracy rate of 59.30% and a false positive rate of 40.70%. There was no complication attributable to this procedure in this study. 

Conclusion Hysteroscopy is a safe, accurate and useful diagnostic method in the evaluation of the uterine cavity in an infertile woman. HSG is a simple, noninvasive and important screening procedure for the study of the uterine cavity and whenever it is combined with hysteroscopy the two techniques are complementary in their application to female infertility.