Hysteroscopy is not included in the routine investigation in the infertile couple. But hysteroscopy is essential for the assessment of the uterine cavity it should be mandatory to perform hysteroscopy when a laparoscopy is being done on a sub fertile woman.
It is a vital tool in analysis of infertile woman in the following situations.
#An intrauterine lesions suspected on Trans vaginal sonography (TVS) or, hystero-salpingo-graphy (HSG)
#Relatively high-risk of intrauterine adhesions as in instrumental interventions in the past (D and C, history of endometritis or, recurrent miscarriage)
#Failure of implantation of good embryos following consecutive IVF cycles.
How hysteroscopy helps prior to Assisted Reproductive Technique (ART)
Though transvaginal sonography is an outstanding diagnostic tool to view uterine pathologies, but hysteroscopy prior to ART as a routine enhance the clinical pregnancy rates, as all intrauterine pathologies cannot be diagnosed precisely on transvaginal sonography.
Patients with recurrent IVF embryo transfer failures after normal hysterosalpingography findings should always be re evaluated using hysteroscopy prior to further commencing IVF-embryo transfer cycle.
Like transvaginal sonography is an extension of per vaginal examination, office hysteroscopy is an extension of transvaginal sonography. Being an out patient procedure, it is completed in just few minutes. Some pathologies like small polyps, intrauterine band of adhesions (which might have been missed on TVS) can easily be viewed directly and tackled by bipolar or, monopolar electric cautery in the same sitting. It also gives light on the curvature of the cervical canal, which helps in the embryo trap procedure subsequently. It also helps to tackle tightly closed internal os or flimsy adhesions at internal os before embryo transfer than at the time-embryo transfer.
his article is also published in India Study Channel
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