Hysteroscopy for Infertile Patient

Posted by e-Medical PPT Saturday, April 28, 2012
A rigid hysteroscope was superior to a flexible  hysteroscope for outpatient hysteroscopy

Preparation of The Cervix
Vaginal misoprostol prior to diagnostic hysteroscopy reduced cervical resistance in non-pregnant women
Normal saline should be used as it offers: advantages (shorter and less discomfort) over co2 instillation.

Routine  Infertility  Investigation
Tests which have an established
 correlation with pregnancy  are:
1- Semen analysis
2-Tubal patency by HSG or laparoscopy
3-Mid luteal progesterone for the   diagnosis         of ovulation
They are the basic essential tests for diagnosis of infertility
Hysteroscopy should   not be considered as a routine investigation in the infertile couple.

Indications of  Diagnostic Hysteroscopy for Reproductive Failure
Abnormal hysterosalpingogram.
Abnormal uterine bleeding
Suspected intrauterine pathology
Uterine anomalies
Pregnancy wastage
Unexplained infertility

Hysteroscopy done at laparoscopy time, has low complication rate,high degree of safety, minimal time requirement and adds little equipment & cost.

Unexplained infertility
Small endometrial polyp
Small cervical polyp
Adhesion at cornual cones
Cornual polyp

Endometrial dystrophies(atrophy or hyperplasia) that may affect  receptivity or implantation especially in  ART.

Indications of  Operative Hysteroscopy for Reproductive Failure
Submucous leiomyoma.
Uterine septa.
Intrauterine Adhesions.
Misplaced or embedded IUD
Tubal cannulation and Falloposcopy...

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