Validity and efficacy of office hysteroscopy before in vitro fertilization treatment

Office hysteroscopy (OH) allows assessment of the uterine cavity. The aim of this study is to investigate uterine cavity of infertile patients with OH, to treat pathologies and to measure the impact of OH on live birth rates and IVF treatment costs.

498 IVF patients were selected for this study. Control group (398 patients) underwent IVF without OH evaluation. OH group (100 patients) was assessed prior to IVF and detected intrauterine pathologies were treated. OH group was divided into two subgroups: patients with normal uterine cavity (59 patients) and patients who had intrauterine pathologies (41 patients). Number needed to treat (NNT) was also measured.

When live birth rates of the control and OH groups were compared, OH group's rate was significantly higher (18.3 vs. 26 %; p > 0.05). 41 % of the patients in the OH group had intrauterine pathologies. When live birth rates of control group and the subgroups were compared, it was significantly higher in the subgroups (p < 0.05). When live birth rates of the subgroups were compared, there was a statistically significant difference in intrauterine pathology subgroup (p < 0.05). NNT measures showed that 13 OH interventions were needed to achieve one additional pregnancy [NNT 13.05; relative risk (RR) 1.418], while five pathologies had to be found and treated with OH to achieve one additional pregnancy (NNT 5; RR 1.962).

Usage of OH can play an important role in detecting intrauterine pathologies in IVF patients. Therefore, it may have a positive impact on pregnancy outcome and treatment costs.