The IVF check most women don’t need

The method means that each round of IVF is far more likely to succeed " sparing couples the agony of repeated attempts at having a child.

The method means that each round of IVF is far more likely to succeed " sparing couples the agony of repeated attempts at having a child.

Published Jul 11, 2014

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London - Thousands of women trying for a baby through IVF are undergoing unnecessary and expensive procedures to examine the womb, warn doctors.

Research shows that having a hysteroscopy to check the womb before fertility treatment makes almost no difference to success rates.

But some private clinics insist on the invasive procedure, which costs up to £3 000 a time, before giving IVF.

Dr Tarek El-Toukhy, from Guy’s and St Thomas’s Hospital, London, who led the study, said: “Based on these findings, hysteroscopy before IVF doesn’t significantly improve IVF results and cannot be considered essential for women with recurrent IVF failure.”

There has been a long-running debate over whether to perform hysteroscopies on those who have failed to become pregnant after one or more IVF attempts.

Almost 50 000 women have IVF treatment every year in the UK, and hysteroscopies, often carried out under general anaesthetic, are standard in many clinics whether or not there have been problems conceiving. During the procedure, a doctor examines the womb using a narrow tube with a camera at the end to send images to a computer, where they can be checked for problems such as scar tissue that may cause infertility.

If any abnormal growths are detected they are subsequently removed using a repeat procedure.

In a trial involving eight fertility centres in Europe, 700 women who had an unsuccessful round of IVF were randomly assigned either a hysteroscopy before a second attempt, or put straight through for IVF again. Abnormalities of the womb were found in one in ten women having a hysteroscopy. But using the procedure and treating such problems made no significant difference to a woman’s chances of going on to have a baby, the researchers found.

The birth rate was 31 percent in the hysteroscopy group and 29 percent in women who had IVF alone.

Dr El-Toukhy said the finding suggested the abnormalities found were not interfering with the woman’s chances of pregnancy.

He said hysteroscopy was justified in women where an abnormality in the womb was found by ultrasound, but not as a routine procedure prior to IVF.

“The results indicate that routine outpatient hysteroscopy in women who have experienced two to four failed IVF attempts do not significantly improve the subsequent IVF outcome,” he said.

The findings were reported at the annual meeting of the European Society of Human Reproduction and Embryology in Munich. Dr Yacoub Khalaf, a fertility expert from King’s College London, said: “In some clinics, the first thing they do is hysteroscopy before the patients get any IVF. It’s standard in some clinics and could cost £2 000 to £3 000 under general anaesthetic. It’s an unpleasant experience and this study shows it does not add value.”

Non-invasive ultrasound would identify such problems in the womb for most women, he said.

Professor Allan Pacey, chairman of the British Fertility Society, said hysteroscopy was often used even in NHS clinics, costing around £500-£600 a time. He said the money could be better spent on giving women more IVF treatment. - Daily Mail

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