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Hysteroscopy for treating subfertility associated with suspected major uterine cavity abnormalities


Bosteels, J., et al

Subject Keywords: Hysteroscopic removal, Endometrial polyps, Submucous fibroids, Uterine septum, Intrauterine adhesions, Ultrasound, Hysterosalpingography, Diagnostic hysteroscopy, Intrauterine insemination (IUI), In vitro fertilisation (IVF), Intracytoplasmic sperm injection (ICSI)
Region: International (other)

Human life starts when a fertilised egg has successfully implanted in the inner layer of the cavity of the womb. It is believed that abnormalities originating from this site, such as polyps, fibroids, septa or adhesions, may disturb this important event. The removal of these abnormalities by doing a so-called hysteroscopy using a very small diameter inspecting device might therefore increase the chance of becoming pregnant either spontaneously or after specialised fertility treatment, such as intrauterine insemination or in vitro fertilisation. This review identified no studies reporting live birth as an outcome. We found one study on the removal of fibroids in women with unexplained infertility. It suggests that there might be a higher chance of conceiving after surgery compared to regular sexual intercourse for 12 months. Due to the low number of women (94) and the low number of pregnancies (30) the differences are not statistically significant. The quality of the study is very low. Therefore uncertainty remains about the real value of removal of fibroids in raising the chance of conception in women having difficulty becoming pregnant. We found only one study on hysteroscopy in 215 women with polyps who were to be treated with insemination for various fertility problems. The findings support an important increase in the pregnancy rates after the hysteroscopic removal of polyps. Although the quality of this study is high, further studies are needed to confirm this result. Neither of the two studies reported data on the surgical complications of hysteroscopy.

More studies are needed before hysteroscopy can be proposed as a fertility-enhancing procedure in the general population of women having difficulty becoming pregnant.



Rights: © The Cochrane Collaboration
Suggested citation:

Bosteels, J., et al. (2013) Hysteroscopy for treating subfertility associated with suspected major uterine cavity abnormalities [Online]. Available from: [Accessed: 20th July 2019].


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