Uterine evaluation by microhysteroscopy in IVF candidates

Over an eight-month period, microhysteroscopy was performedon 180 women, candidates for in-vitro fertilization (IVF). Onehundred and two of them were suspected of having uterocervicalpathology (group I), and 78 were not (group II). Group I hadmicrohysteroscopic abnormalities in 60.8% and group II in 21.8%.Microhysteroscopy showed 30.6% of 36 positive hysterographiesto be false positive and 37.5% of 144 negative hysterographiesto be false negative, producing a confirmation rate of 63.9%.Admission to the IVF programme depended on microhysteroscopicnormality. One hundred and one women were accepted directly,and 20 refused (‘primary decision’). Fifty-ninewere deferred with treatable hysteroscopic abnormalities, pendingmedical (22) and surgical (37) treatment, 14 via the microhysteroscope.Of the 59 women deferred, 51 were finally admitted and 8 rejectedafter a microhysteroscopic check (‘secondary decision’).Finally, 152 of the 180 candidates (84.4%) were admitted. Microhysteroscopyhelped to determine the optimal route for embryo transfer in23 women with cervical pathology. Term pregnancy rates per embryotransfer were similar with hysteroscopic findings primarilynormal, or normal after successful treatment (11.2 and 10.8%respectively). Microhysteroscopy seems useful for selectionof cases for IVF, accurately determining utero-cervical pathologyor normality, aiding in surgical correction of abnormalitiesand facilitating the process of embryo transfer. We suggestthat microhysteroscopy should be performed routinely on allIVF candidates.