Introduction: Uterine cavity pathologies often lead to decreased rates of infertility. Correction of these anomalies has been associated with improved pregnancy rates. Diagnostic hysteroscopy can be performed with minimal discomfort and superior sensitivity, and specificity in the evaluation of the uterine cavity, even before in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). To date, there are many centers where hysteroscopy is being ignored as an essential preliminary workup. This study was done to evaluate the importance of hysteroscopy in the workup of such infertile women.
Aim: To study the role of hysteroscopy in the workup of infertility.
Objectives: Hysteroscopic evaluation of infertile patients fulfilling the inclusion criteria. To determine the importance of hysteroscopy in treating endometrial lesions.
Materials and methods: A retrospective cohort study was done at a tertiary care hospital in Himachal Pradesh, India, for a period of 12 months, where case sheets of 90 patients, who underwent hysteroscopy as a workup of infertility, were assessed. Inferences were noted and conclusions were made. Statistical analysis was performed using Fisher's exact test. The p-value of <0.05 was considered significant.
Results: Among a total of 90 patients included in the study, 65 patients (72.2%) presented with primary infertility, and the remaining 25 patients (27.8%) had secondary infertility. Normal findings on ultrasound were seen in 65 patients (72.2%). This was in contrast to 38 patients (42.2%), who had normal hysteroscopic findings. This revealed that hysteroscopy had a greater sensitivity and a 30% higher rate of detection of uterine abnormalities as compared to the ultrasound done routinely in the infertility workup. Therapeutic hysteroscopy was performed in 29 cases (32.22%) to correct uterine cavity defects and to improve fertility rates. Hence it was found that hysteroscopy can diagnose uterine cavity defects even in patients with normal ultrasound findings. Therefore hysteroscopy should be used as a primary tool in the infertility workup.
Conclusion: This study concluded that routine infertility workups should include hysteroscopy as a primary tool.
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