Use of hysteroscopy before ICSI
What problem was addressed? There is need to define use of diagnostic and operative hysteroscopy before ICSI in evaluating, treating abnormalities of uterine cavity, and to evaluate sensitivity and specificity of hysteroscopy in diagnosis of endometritis, in infertile women attending National infertility center, Misurata Libya. Use of hysteroscopy before ICSI helps in tackling of uterine factors, and can improve the outcomes, reduce the costs, and alleviate anxiety due to failure of ICSI.
What was tried? Interventional prospective study of 208 infertile cases candidate for ICSI. Hysteroscopy used to diagnose and treat abnormalities detected before ICSI. Evaluation of sensitivity, specificity, calculated to assess diagnostic hysteroscopy for detecting endometritis in infertile female.
What lessons were learned? Abnormal uterine findings were detected in 89.2% of cases, treated before starting ICSI. Hysteroscopy showed 90.2% sensitivity and 90% specificity in evaluation of endometritis. After use of diagnostic hysteroscopy pregnancy occurred spontaneously in 12.9% of cases and in 26.9% after ICSI. Between the two groups there was significant difference statistically only in the duration of infertility and presence of adhesions.
Use of hysteroscopy before ICSI has high sensitivity and specificity in detecting endometritis. Hysteroscopic use can by itself improve the chances of spontaneous pregnancy..