|Can Hysteroscopy Be Advised To Be Done In Infertile Women Candidate For Laparoscopy With A Normal Cavity of The Uterus in Hysterosalpingography?|
|Maliheh Amirian1, Anis Darvish Mohammadabad2, Negar Morovatdar3, Leili Hafizi2|
|1Department of IVF and Infertility, Milad infertility Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IRAN
2Department of Obstetrics and Gynecology, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IRAN
3Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IRAN
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Keywords : Hysterosalpingography, Hysteroscopy, Laparoscopy, Infertility, Uterine factor
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Objectives: Endometrial pathologies inside the cavity can occur simultaneously with gestational unpleasant consequences and are not always capable of being diagnosed byhysterosalpingography (HSG). This study aims to examine the value of performing diagnostic hysteroscopy beside diagnostic laparoscopy among infertile women with normal uterine cavities in HSG.
Materials and Methods: In this cross-sectional study, after receiving their informed consent on the basis of inclusion and exclusion criteria, all 18-40-year infertile women referring to Imam Reza Hospital between 2016 and 2017 who were candidates of laparoscopy and had normal uterine cavities in the hysterosalpingography (HSG) were involved in the project. Hysteroscopy was performed simultaneously with diagnostic laparoscopy. The existence of uterine pathologies like endometrial polyps, submucousmyoma, uterine endometrial adhesions and their relationship with the patient’s age, infertility’s type and duration and cycle time were evaluated. A p-value less than0.05 was considered to be statistically significant.
Results: Overall, 64 patients (63.1 percent) had a normal uterine cavity in the hysteroscopy and 39 patients had abnormal uterine cavity, HSG’s false negative cases of which were reported to be 37.9%. The pathologies found in the hysteroscopy, were endometrial polyp (16 cases), submucousmyoma (1 case), uterine septum (6 cases), asherman syndrome (7 cases), bicornuate uterus (4 cases), polyp + asherman (3 cases), polyp + submucousmyoma (1 case), and septum + submucousmyoma (1 case).Patients’ age, type of infertility, and menstruation time during performing hysteroscopy made no particular difference in diagnosing pathologies of the uterine cavity in the hysteroscopy.
Conclusion: According to this study, doing hysteroscopy in infertile women who are candidates of laparoscopy and have normal uterine cavities in HSG can lead to recognizing some cases of uterine pathologies which influence the results of future pregnancies, the issue which does not depend upon patient’s age, menstruation time, type and durationof infertility, and laparoscopy’s result.
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