Article
Outpatient hysteroscopy and subsequent IVF cycle outcome: a systematic review and meta-analysis

https://doi.org/10.1016/S1472-6483(10)60486-5Get rights and content

Abstract

A systematic review of studies evaluating the influence of outpatient (office) hysteroscopy on the outcome of the subsequent IVF cycle was conducted. MEDLINE, EMBASE, the Cochrane Library, National Research Register, ISI Conference Proceedings, ISRCTN Register and Meta-register were searched for randomized controlled trials (up to July 2007). All trials comparing the outcome of IVF treatment performed in patients who had outpatient hysteroscopy in the cycle preceding their IVF treatment with a control group in which hysteroscopy was not performed were included. Study selection, quality appraisal and data extraction were performed independently and in duplicate. Study authors were contacted for additional information. The main outcome measure was pregnancy rate. In total, 1691 participants were included in two randomized (n = 941) and three non-randomized controlled studies (n = 750). The quality of the studies was variable. Meta-analyses of the results of five studies showed evidence of benefit from outpatient hysteroscopy in improving the pregnancy rate in the subsequent IVF cycle (pooled relative risk = 1.75, 95% CI 1.51–2.03). The evidence from randomized trials was consistent with that from non-randomized controlled studies. Future robust randomized trials comparing outpatient hysteroscopy or mini-hysteroscopy with no intervention before IVF treatment would be a useful addition to further guide clinical practice.

Section snippets

Tarek El-Toukhy obtained his medical qualification (MBBCh) in 1991, MSc in 1996 and MD in 1998 from the Department of Obstetrics and Gynaecology in Cairo University, Egypt. He was admitted as a member of the Royal College of Obstetricians and Gynaecologists in London in 1998. He then worked as a fellow in Reproductive Medicine in the Assisted Conception Unit at Guy's and St Thomas' Hospital in London between 2000 and 2003. He joined the Assisted Reproduction and Gynaecology Centre in London in

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    Tarek El-Toukhy obtained his medical qualification (MBBCh) in 1991, MSc in 1996 and MD in 1998 from the Department of Obstetrics and Gynaecology in Cairo University, Egypt. He was admitted as a member of the Royal College of Obstetricians and Gynaecologists in London in 1998. He then worked as a fellow in Reproductive Medicine in the Assisted Conception Unit at Guy's and St Thomas' Hospital in London between 2000 and 2003. He joined the Assisted Reproduction and Gynaecology Centre in London in 2003. His current research interests are preimplantation genetic diagnosis for genetic disorders and aneuploidy screening.

    Declaration: The authors report no financial or commercial conflicts of interest.

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