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Related Experiment Video

Updated: Jul 25, 2025

Author Spotlight: A Reproductive Hysteroscopy Approach for Complete Endometrial Polyp Removal and Enhanced Endometrial Receptivity

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Published on: August 2, 2024

A Controversial Old Topic Revisited: Should Diagnostic Hysteroscopy Be Routinely Performed Prior to the First IVF

María Carrera Roig¹, Federico Pérez Milán², Luis Alonso³

¹Hospital Universitario Doce de Octubre (Dr. Roig), Madrid, Spain.

Journal of Minimally Invasive Gynecology

|June 28, 2023

Summary

Routine hysteroscopy before the first in vitro fertilization (IVF) cycle significantly boosts clinical pregnancy rates. However, this pre-IVF diagnostic procedure does not appear to impact live birth rates in women undergoing assisted reproductive technology.

Keywords:

ART Assisted reproduction Clinical pregnancy Hysteroscopy IVF In vitro fertilization Live birth Ongoing pregnancy Outcome Uterine anomalies Uterine pathology

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Published on: January 22, 2022

Area of Science:

Reproductive Medicine
Gynecology
Infertility Treatment

Background:

The efficacy of diagnostic hysteroscopy prior to the initial in vitro fertilization (IVF) cycle remains a subject of investigation.
Optimizing outcomes for assisted reproductive technology (ART) necessitates evaluating preliminary diagnostic procedures.

Approach:

A systematic review and meta-analysis synthesized data from 12 studies (including RCTs, cohort, and case-control studies) involving 5056 patients.
Searches encompassed major databases (PubMed, Embase, Web of Science, Cochrane) and clinical trial registries up to June 2022.
Studies comparing hysteroscopy before IVF versus direct IVF were included for quantitative synthesis.

Key Points:

Performing hysteroscopy before the first IVF cycle was associated with a significantly higher clinical pregnancy rate (OR, 1.49; 95% CI, 1.16-1.91).
Sensitivity analysis limited to randomized clinical trials confirmed this finding for clinical pregnancy (OR, 1.62; 95% CI, 1.15-2.29).
No statistically significant difference in live birth rates was observed between the hysteroscopy and no-hysteroscopy groups (OR, 1.24; 95% CI, 0.94-1.64).

Conclusions:

Routine diagnostic hysteroscopy before the first IVF attempt appears to enhance clinical pregnancy rates.
The current evidence does not support an improvement in live birth rates when hysteroscopy is performed prior to the initial IVF cycle.
Further research may clarify the role of hysteroscopy in specific patient subgroups within ART.