Obstetric outcomes of women undergoing office hysteroscopy in infertility conditions: a retrospective cohort study

Purpose To present and compare obstetric outcomes in women undergoing office hysteroscopy (OH) during the diagnostic evaluation and ineffective treatment of infertility due to various underlying factors. Methods The retrospective study included women experiencing infertility of diverse type and etiology. Obstetric outcomes, including rates of live births, clinical and biochemical pregnancies, and time to conception, were compared within four preoperative diagnosis groups (idiopathic infertility, uterine polyp, uterine factors other than polyps, and other conditions) and four postoperative diagnosis groups (uterine polyp, clinical features of chronic endometritis (CE), uterine factors, and other findings), taking into account the status of chronic endometritis. Results Among preoperative diagnoses, women undergoing hysteroscopy for recurrent miscarriages had the highest percentage of pregnancies, while those with polyps had the lowest (p = 0.012). With a positive CE status and empirical antibiotic treatment, the highest pregnancy rate was in women with idiopathic infertility, while the lowest was in those with polyps (p = 0.011). Regarding hysteroscopic findings, the highest percentage of achieved pregnancies occurred in women undergoing resection of a uterine septum or intrauterine adhesions, while the lowest was observed in those following polypectomy (p = 0.036). No differences in obstetric outcomes were noted concerning CE status. None of the hysteroscopic findings were independent prognostic factors for live birth. Conclusion In planning hysteroscopy for idiopathic infertility, verifying CE status is recommended to facilitate treatment and improve obstetric outcomes if positive. The removal of a uterine septum or intrauterine adhesions enhances the rate of achieved pregnancies, regardless CE status.