Kumar Praveen, Mohan Surender, Talwar Pankaj, Rai Seema, Nagaraja N, Sharma Prashant
ART Centre, Army Hospital (Research & Referral), Delhi Cantt, India.
J Obstet Gynaecol India. 2017 Aug;67(4):275-281. doi: 10.1007/s13224-017-0972-9. Epub 2017 Feb 10.
The aim of this study was to analyze the utility of routine use of diagnostic office vaginohysteroscopy in the evaluation of uterine cavity in infertility patients prior to IVF-ET.
We conducted a retrospective analysis of 1000 women who had undergone routine diagnostic office vaginohysteroscopy as an institutional protocol in the evaluation of infertility prior to IVF-ET cycle at a tertiary care hospital. They were divided into two groups: primary infertility (group I) and secondary infertility (group II). The primary outcome was the finding of an abnormal uterine cavity (congenital abnormality vs acquired abnormality).
One thousand women underwent routine diagnostic office vaginohysteroscopy in the evaluation of infertility prior to IVF-ET. There were no intraoperative or postoperative complications. Vaginohysteroscopy revealed an abnormal uterine cavity in 13.8% (1000 patients) of women. Primary infertility group (I) had 13.19% (811 patients), and secondary infertility group (II) had 16.4% (189 patients) abnormal uterine cavities.
Diagnostic office vaginohysteroscopy has a definite role in the uterine cavity evaluation in infertility patients prior to IVF, but routine use should not be recommended considering the low incidence of abnormal uterine cavity findings. Moreover, the majority of these uterine cavity abnormalities can be detected by less invasive tests such as HSG, TVS, SSG and 3D ultrasound.
本研究旨在分析在体外受精-胚胎移植(IVF-ET)前对不孕患者常规使用诊断性门诊阴道宫腔镜检查评估子宫腔的效用。
我们对一家三级医疗机构中1000名接受常规诊断性门诊阴道宫腔镜检查的女性进行了回顾性分析,这些检查是该机构在IVF-ET周期前评估不孕情况的方案。她们被分为两组:原发性不孕(第一组)和继发性不孕(第二组)。主要结局是发现子宫腔异常(先天性异常与后天性异常)。
1000名女性在IVF-ET前接受了常规诊断性门诊阴道宫腔镜检查以评估不孕情况。术中及术后均无并发症。阴道宫腔镜检查发现13.8%(138例)女性子宫腔异常。原发性不孕组(第一组)子宫腔异常率为13.19%(81例),继发性不孕组(第二组)为16.4%(19例)。
诊断性门诊阴道宫腔镜检查在IVF前不孕患者子宫腔评估中具有明确作用,但鉴于子宫腔异常发现率较低,不建议常规使用。此外,这些子宫腔异常大多可通过侵入性较小的检查如子宫输卵管造影(HSG)、经阴道超声(TVS)、子宫输卵管超声造影(SSG)和三维超声检测出来。