Role of office hysteroscopy in the evaluation of infertile women after controlled ovarian stimulation/intra uterine insemination failure

ObjectiveTo assess the role of office hysteroscopy (OH) in the evaluation of infertile women with normal HSG who fail to conceive after undergoing controlled ovarian stimulation/intrauterine insemination (COS/IUI).DesignProspective cohort study.Materials and methodsThe study included 141 patients with absent pelvic pathology on trans vaginal sonography and HSG and history of failed three or more trials of COS/IUI. Office hysteroscopy was then done and any detected intrauterine pathology was recorded.ResultsA total of 141 patients were examined by OH of which 26 patients proved to have uterine pathology, giving a false negative rate of (18.4%) of HSG. The overall agreement between HSG and OH was 81.6%.ConclusionSignificant uterine pathology was proved in 18.4% infertile women in spite of normal HSG results. OH has a role in infertile women with no obvious abnormality on HSG before they proceed to more aggressive treatment.