The Efficacy of Hysteroscopy: A Comparison of Women Presenting With Infertility Versus Other Gynaecological Symptoms

The aim of this study was to compare the relative efficacy of hysteroscopy as a management tool in the routine initial assessment of women presenting for investigation of infertility with women presenting for investigation of other general gynaecological symptoms for which it is routinely performed. The results of 400 consecutive completed hysteroscopies performed during the primary investigation of infertility are compared with 400 consecutive completed hysteroscopies undertaken in the investigation of women with other gynaecological symptoms. Abnormalities were detected in 12.3% of the 800 hysteroscopies. Significantly less of the infertility group demonstrated abnormality (8.8%) compared to the general gynaecological group (15.8%) (p = 0.0034). There was no difference in the detection rate between primary and secondary infertility. In patients undergoing the procedure for infertility, the results of the hysteroscopy led to an alteration in management in 5.8% of the entire group and in 65.7% of those in whom an abnormality was detected. In patients undergoing the procedure for general gynaecological symptoms, the results of the hysteroscopy led to an alteration in management in 14.5% of the total group and in 97.2% of those in whom an abnormality was detected (p < 0.0001). Structural abnormality correlated with the presence of histological abnormality in 97.2% of cases. In infertile women, the use of hysteroscopy is supported as part of a comprehensive assessment of female reproductive anatomy.