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Surgery Research and Practice
Volume 2014, Article ID 105412, 6 pages
http://dx.doi.org/10.1155/2014/105412
Review Article

What Is the Role of Hysteroscopic Surgery in the Management of Female Infertility? A Review of the Literature

Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais (UFMG), Rua Antonio Torres 186, Sagrada Família, 31030130 Belo Horizonte, MG, Brazil

Received 19 November 2013; Accepted 27 January 2014; Published 3 March 2014

Academic Editor: Giampiero Capobianco

Copyright © 2014 Márcia Mendonça Carneiro. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The position of hysteroscopy in current fertility practice is under debate. There are many randomized controlled trials on technical feasibility and patient compliance demonstrating that the procedure is well tolerated and effective in the treatment of intrauterine pathologies. However, no consensus on the effectiveness of hysteroscopic surgery in improving the prognosis of subfertile women is available. A literature review was performed to explore the available information regarding the role of hysteroscopy in the evaluation and management of female infertility as well as to ascertain evidence that treatment of these uterine abnormalities improves fertility. The debate regarding the role of hysteroscopic surgery in the management of female infertility remains as the published studies did not reach a consensus on the benefit of such an intervention in this setting. The randomized trials do not clearly demonstrate that surgical correction of all intrauterine abnormalities improves IVF outcome. However, published observational studies suggest a benefit for resection of submucosal leiomyomas, adhesions, and endometrial polyps in increasing pregnancy rates. More randomised controlled studies are needed to substantiate the effectiveness of the hysteroscopic removal of suspected intrauterine pathology in women with unexplained subfertility or prior to assisted reproductive technology.