Infertility, Female Clinical Trial
Official title:
Hysteroscopic Evaluation of Uterine Cavity in Women With Unexplained Infertility
Hysteroscopy is still considered the gold standard procedure for uterine cavity exploration. Therefore, many specialists have used hysteroscopy as their first-line of routine exam for infertility patients regardless of guidelines. Thus, scheduling the office micro hysteroscopy as one of the routine steps in the fertility workup program has become mandatory before the final diagnosis of unexplained infertility.
Although hysteroscopy is generally accepted as the gold standard in diagnosis and treatment
of uterine cavity pathology, many gynecologist are reluctant to perform hysteroscopy as an
initial test without a high degree of suspicion for pathology due to the need for anesthesia
in an operating room setting. The basic infertility work-up has included a HSG to evaluate
the uterine cavity and tubal patency. However, HSG does not allow for simultaneous correction
of uterine pathology. Moreover HSG may miss 35% of uterine abnormalities. Hysterolaparoscopy
(Pan Endoscopic) approach is better than HSG and should be encouraged as first and final
procedure in selected infertile women.
Sonohysterography (SHG) has been proposed as a better diagnostic test of the uterine cavity.
However, it also suffers from a sensitivity and specificity inferior to that of hysteroscopy
in most studies.
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