Hysteroscopy for Infertile Women: A Review

Review Article

Austin J Obstet Gynecol. 2014;1(4): 7.

Hysteroscopy for Infertile Women: A Review

Aarathi Cholkeri-Singh*

Department of Ob/Gynecology, University of Illinois at Chicago, USA

*Corresponding author: Aarathi Cholkeri-Singh, Department of Ob/Gynecology, University of Illinois at Chicago, the Advanced Gynecologic Surgery Institute, 120 Olser Dr, Suite 100 - Naperville, IL 60540, Chicago, USA

Received: July 31, 2014; Accepted: August 31, 2014; Published: September 02, 2014

Abstract

Objective: To review the role of hysteroscopy in infertile women.

Design: Review of peer-reviewed, published literature in PubMed and Cochrane databases on uterine intracavitary pathology, proximal tubal occlusion, failed in vitro fertilization procedures, and first trimester miscarriages of infertile women.

Results: The role of hysteroscopy is well documented in infertile women. Diagnostic and operative hysteroscopy are effective when evaluating and treating uterine intracavitary pathology, proximal tubal occlusion, failed in vitro fertilization procedures, and first trimester miscarriages of infertile women.

Conclusion: In conclusion, hysteroscopy may play an important role prior to or in conjunction with assisted reproductive techniques to help infertile women and couples achieve their goals of a pregnancy and live birth of a child.

Keywords: Hysteroscopy; Infertile women; Recurrent pregnancy loss

Introduction

In 2002, about 2.1 million women in the U.S were infertile. According to the National Center for Health Statistics, it was tabulated that between 2006 and 2010, rates of infertility were to range 8-30% for married women ages 15-44 years [1]. Assisted reproductive technology has been used to treat many of these women. However, hysteroscopy has been proven within peer-reviewed published literature to be a valuable tool for diagnosis and treatment of some infertile women prior to or after undergoing assisted reproductive techniques.

Hysteroscopy indications for infertile women include intracavitary abnormalities, such as sub mucous fibroids, endometrial polyps, uterine septum, adhesions, and retained products of conception. In addition, the role of hysteroscopy in proximal tubal occlusion, failed IVF cycles and first-trimester miscarriages is also valuable.

Intracavitary Pathology

Submucous fibroids

Submucous fibroids are categorized as Type 0, 1, and 2. A Type 0 fibroid is located completely within the uterine cavity; Type 1 fibroid is ≥ 50% within the uterine cavity (Figure 1A); and Type 2 is < 50% within the uterine cavity [2]. Postulated mechanisms by which fibroids cause infertility include the following: