Table 2.
Characteristics and findings of hysteroscopy in included RCTs
| Author, publication year | Abnormal hysteroscopy |
Etiology of unsuspected lesions1 | Instrument | Anesthesia/ Sedation |
Timing of procedure/subsequent ART |
|---|---|---|---|---|---|
| Demirol et al. (2004) | 26.7% |
EM polyps 15.7% IUA 8.5% Cervix stenosis 2.3% |
5 mm diameter with 5 Fr working channel, 30° view (Bettocchi) | Midazolam 0.1 mg/kg IV when needed | Early follicular phase/NA |
| Raju et al. (2006) | 38.0% |
EM polyps 12.8% Abn Cervix 12% IUA 4.8% EM hyperplasia 4.8% Fibroids 0.4% Anomalies2 3.2% |
5 mm diameter with 5 Fr working channel, 30° view (Krishna) | Midazolam 0.1 mg/kg IV when needed | NA/NA |
| Shawki et al. (2012) | 33.4% |
EM polyps 10.8% IUA 3.8% Fibroids 3.8% Endometritis 1.9% Anomalies2 0.9% EM hyperplasia 2.8% |
3.5 mm diameter, 0° view (Versascope, Gynecare, Ethicon, Sommerville, NJ, USA) | None | NA/NA |
| Elsetohy et al. (2014) | 43.3% |
EM polyps 13.4% Anomalies2 10.4% Fibroids 7.2% IUA 6.2% |
4.3 mm diameter with 5 Fr working channel, 30° view | NA | Early to mid-follicular phase/Start ICSI cycle within 3 months |
| Alleyassin et al. (2015) | 22.7% |
Anomalies2 13.6% EM polyps 5.4% IUA 0.9% EM hyperplasia 1.8% |
4 mm diameter rigid hysteroscopy, 30°view | None | Mid-luteal phase/Start ICSI next cycle |
| Smit et al. (2016) | 13.0% |
EM polyps 9.5% Anomalies2 2.3% Fibroids 1.3% IUA 1% |
5 mm diameter with 5 Fr working channel, 30° view | Paracervical block when needed | Early to mid-follicular phase/Start ICSI cycle within 3 months |
| El-Toukhy et al. (2016) | 26.0% |
Anomalies2 8% Cx stenosis 4% EM polyps 3%3 IUA 0.9% |
2.9 mm diameter rigid hysteroscopy, 30° view (TROPHYscope; Karl Storz, Tuttlingen) | None | Follicular phase/Started IVF in the following month |
| Abid et al. (2021) | 31.0% |
IUA 13% EM polyps 8.3% Endometritis 8.3% Fibroids 1.2% |
2.9 mm diameter (26,120 BA STORZ) | Analgesic treatment level 2 (Paracetamol/Codeine 500 mg/30 mg) 1 h before the procedure | Mid-follicular phase/Started IVF in the following month |
| Pounikar et al. (2022) | 40.0% | NA | NA | NA | NA/Started IVF in the following month |
| Ghasemi et al. (2022) | NA | NA | 5 Fr working channel, 30° view4 | NA | Early to mid-follicular phase/NA |
ART, artificial reproductive treatment; EM, endometrial; IUA, intrauterine adhesion; Cx, cervix; IV, intravenous; NA, not available; ICSI, intracytoplasmic sperm injection
1 The percentage was calculated based on the number of patients who received hysteroscopy
2 The anomalies include septate, arcuate, or bicornuate uterus
3 The incidence included 1% micropolyps
4 The study did not report the diameter of the hysteroscopy