During this event, Dr José Félix García España, Medical Director of UR El Ángel talked about hysteroscopy and whether it can improve IVF outcomes, its indications, and how the procedure is done.
Dr José Félix García España sated that:
50% of what we are firmly established in medicine today will be refuted in 15 years’ time, but the problem is that we don’t know what 50% is.
Hysteroscopy, a procedure involving visual examination of the uterus, merits distinction between its diagnostic and surgical forms. The diagnostic variant aids in spotting abnormalities while the surgical kind involves interventions to rectify detected issues.
A crucial aspect involves discerning the circumstances under which diagnostic hysteroscopy proves invaluable. Exploring this facet unveils disparities in expert opinions. While some emphasize its role, others contend its significance isn’t fully validated. A quote exemplifies this dilemma:
Hysteroscopy in asymptomatic women prior to the first IVF cycle could be associated with improved treatment outcome.However, it also underlines the necessity for rigorous research to confirm findings.
Surgical hysteroscopy emerges as a critical tool for addressing specific uterine pathologies. These include issues like fibroids, polyps, and adenomyosis that can hinder successful implantation. Surgical correction, often involving minimally invasive procedures, becomes paramount in optimizing the uterine environment for embryo development.
The medical community grapples with understanding conditions like dysmorphic uteri and chronic endometritis. The former pertains to irregular uterine shapes, and opinions differ on its impact. Similarly, chronic endometritis, an asymptomatic condition, is subject to debate regarding its significance. Conflicting evidence underscores the need for robust research to ascertain their clinical relevance.
The challenge of determining when to recommend hysteroscopy is multifaceted. Navigating between standardized protocols, evolving medical knowledge, and patient expectations is complex. Different medical settings—public versus private—also influence decision-making, creating a dynamic landscape.
Hysteroscopy and laparoscopy are both minimally invasive procedures that use cameras to diagnose and treat conditions that affect your uterus and other reproductive organs.
Hysteroscopy does not require any incisions (cuts) because the tools for the procedure are inserted through the vagina. However, a laparoscopy requires the surgeon to make one or more small incisions in your abdomen (stomach). Laparoscopies have a slightly higher risk of complications from infection and bleeding since the surgeon has to make one or more incisions, unlike a hysteroscopy.
Some patients will need a laparoscopy if a procedure cannot be done through the vagina, or your surgeon is concerned about the risk of injury to other organs during hysteroscopy.
In conclusion, the subject of hysteroscopy in fertility treatment embodies a myriad of complexities. Balancing diagnostic and surgical applications, understanding varied pathologies, and adapting to a rapidly evolving medical landscape all contribute to the intricate nature of this field. As we grapple with uncertainties and await further research, a spirit of adaptability and openness becomes crucial.- Questions and Answers