Role of hysteroscopy in the evaluation of the infertile patient: A retrospective study

Objective: To identify the role of hysteroscopy as a diagnostic investigation in the management of the patient with problems of infertility or previous pregnancy losses. Methods: Five hundred and twenty-one patients referred to the Hysteroscopic Centre of the Department of Obstetric and Gynaecology of the University of Florence for reproductive problems (sterility or abortivity) were retrospectively studied. Hysteroscopic aspects of the uterine cavity, cervical canal and tubal orifices were observed. Results: The most significant pathology was uterine malformations (82% of pathological cases) and in particular uterine septa (44%) and arcuate uterus (49%). Anomalies of the cervical canal were low (6%) and represented by stenosis (3,5%) and incompetence (1,7%). Morphologic aspects of tubal orifices showed a pathologic feature in 9,4% of cases; the most prevalent alteration observed being a stenotic orifice in 57,4% patients. Conclusions: Hysteroscopy maintains a second level role as a diagnostic investigation in infertility but our data confirm the importance of identifying those pathologies, such as mullerian anomalies, that need an early diagnosis for an adequate surgical treatment.