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At least 19 recordsLinked to original sources
PubMed2026

Hysteroscopic platelet-rich plasma and medically assisted reproduction outcomes: a systematic review and SWOT analysis.

BACKGROUND: Platelet-rich plasma (PRP) has been proposed as an adjuvant treatment in reproductive medicine. While most evidence refers to blind intrauterine instillation, subendometrial administration under hysteroscopic guidance allows targeted delivery under direct visualisation. This systematic review aimed to synthesise the available evidence on hysteroscopic PRP administration and its impact on clinical medically assisted reproduction (MAR) outcomes. METHODS: A systematic search was conducted from inception to December 2025 across major databases. Studies were included if they evaluated hysteroscopic PRP administration in women undergoing MAR, comparing reproductive outcomes between treated and control groups. RESULTS: Out of 142 records, 3 studies met the inclusion criteria. Study populations were heterogeneous and included women with refractory thin endometrium and/or a history of implantation failure. Hysteroscopic PRP administration protocols varied in timing, technique, and dosage. In a prospective case-control study, hysteroscopic intraendometrial PRP injection at a depth of 2-3 mm in the four uterine walls, using an ovum aspiration needle, on days 11-13 of the cycle prior to euploid frozen embryo transfer (ET), was associated with higher implantation (IR), clinical pregnancy (CPR), and live birth rates (LBR) compared with standard therapy. Conversely, no significant differences in CPR, miscarriage rate, or LBR were observed in an observational study evaluating a single intraendometrial PRP injection (35-40 mL, 2-3 mm depth), administered via endoscopic needle on days 6-8 of the menstrual cycle preceding frozen ET, alone or after electrical impulse therapy. A randomised controlled trial in women undergoing intrauterine insemination reported a significant improvement in CPR following hysteroscopic subendometrial PRP instillation in the four uterine walls (1.0 mL each). CONCLUSIONS: Current literature on hysteroscopic PRP administration in reproductive medicine is limited, and robust conclusions cannot yet be drawn. Well-designed randomised controlled trials with standardised protocols are needed to clarify its clinical role.

Humans↗
PubMed1988

[The development of a new operating hysteroscopic fiberscope and its clinical application].

A new operating hysteroscopic fiberscope consisting of soft and rigid parts (4.8mm outer diameter) was developed with the support of Fuji Photo Optical Company. The working part of the scope can be divided into three sections: A flexible soft front section, a rotary rigid middle section and a flexible self retained semirigid rear section. With these functional parts the intrauterine target can be approached directly to perform the following operations. 1. Directed intrauterine biopsy. Thirty-five patients diagnosed as having endometrial polyp (13), submucous myoma (8), endometrial hyperplasia (4), endocervical polyp (3), endometrial carcinoma (2) and others (5) underwent direct biopsy with hysteroscopic control. No cervical dilatation or anesthesia was necessary. 2. Transcervical recanalization. In six cases of proximal tubal occlusion, a ureteral catheter or a percutaneous coronary balloon angiocatheter was introduced into the tubal ostium of the obstructed side to resolve the occlusion successfully with concomitant laparoscopy. 3. Hysteroscopic chorionic villus sampling. Chorionic villus sampling was performed with a ureteral catheter under direct hysteroscopic control and ultrasound guidance in eighteen pregnant women at from seven to fourteen gestational weeks. In fifteen cases, the samplings were performed satisfactory. 4. Removal of a lost IUD. Three cases of lost IUD underwent hysteroscopic removal without difficulty. Our results have proved that this scope is a very useful tool for intrauterine operations.

Adult↗
PubMed1987

[Contact hysteroscopic exploration of the uterine cavity].

The contact hysteroscope gives a clear view only upon contact with the observed surface. There are 6mm and 8mm diameter models. A total of 172 contact hysteroscopic examinations were performed to view the uterine cavity. The following results were obtained: After the previous observation with the panoramic hysteroscope, the rate of correct diagnosis with the 6mm model was 83.3% and that with the 8mm one was 98.5%. The rate of correct diagnosis with the 8mm model was 85.3% and that with the 6mm one was 92.7%, when used initially. The main disadvantages of the contact hysteroscope were a lack of perspective view and occasional existence of a dead angle just above the internal os. Among the contact hysteroscopic diagnosis, that of endometrial polyp was the most difficult, followed by those of slightly bulging submucous myoma and endometrial hyperplasia, while diagnosis of IUD, hydatidiform mole and endometrial carcinoma were easier. After acquiring the necessary experience, the 6mm model also gave very accurate results, requiring no cervical dilatation in multiparous cases. The 6mm model should therefore be a useful instrument to use in outpatient diagnosis.

Endoscopes↗
PubMed1975

Development of a steerable hysteroscope: studies in the baboon.

A steerable fiberoptic hysteroscope was developed with an integrated fluid circulatory system and a channel that can be used either for operative procedures or for the passage of a uterotubal occlusive device delivery assembly. The hysteroscope was demonstrated to be a safe and practical instrument for intrauterine observations, using the baboon as the animal model. Postpartum baboons were used for a majority of the experiments since the cervix of most cycling animals could not be sufficiently dilated to permit hysteroscope insertion. Estrogen-progesterone treatment resulted in softening of the cervix enough to allow hysteroscopic examination in 66 per cent of the animals so treated. Hysteroscopy was performed on 18 baboons. In almost all cases the uterotubal junctions were visualized and appeared as small slits or depressions. Measurements of the mean uterine length, fundal width, normal cervical diameter, and the diameter to which the cervix can maximally be dilated are reported for cycling, hormone-treated, and postpartum baboons.

Animals↗
PubMed1977

Transcervical tubal occlusion with a steerable hysteroscope: implantation of devices into extirpated human uteri.

A new steerable fiberoptic hysteroscope particularly useful in visualizing the tubal ostia has been evaluated in 61 extirpated uteri. The efficacy and safety of this hysteroscope were shown. The feasibility of deploying occlusive devices into the intramural portion of the tubes with the steerable hysteroscope was demonstrated. Whether these devices or modifications thereof will prove to be superior to other currently tested methods of occlusion, e.g., caustics, plastics, or cautery under in vivo conditions, remains to be established. The steerability of the hysteroscope has advantage irrespective of the method to achieve transcervical tubal occlusion as it allows coaxial alignment of the delivery.

Adult↗
PubMed1992

Hysteroscopic treatment of septate uterus with Neodymium-YAG laser.

OBJECTIVE: To determine the effectiveness of Neodymium-YAG (Nd-YAG) laser for hysteroscopic transection of the septate uterus to improve pregnancy outcome. DESIGN: Patients treated for recurrent pregnancy loss and/or infertility were evaluated for before versus after treatment pregnancy outcomes. SETTING: All patients were referred to a University Reproductive Endocrine and Infertility practice from 1986 through 1990. PATIENTS, PARTICIPANTS: Nineteen patients underwent hysteroscopic transection of uterine septa after exclusion of other factors that may cause recurrent fetal wastages and/or infertility. They were allowed to conceive 8 weeks after surgery after a postoperative hysterosalpingogram. Fourteen women attempted conception during a time span of 11 to 42 months; 3 patients declined to conceive, and 2 were lost to follow-up. INTERVENTIONS: Hysteroscopic transection of the uterine septum with a Nd-YAG laser was performed in all patients. The Nd-YAG laser delivered via a 600-microns bare fiber or an 800-microns sculpted fiber through operative hysteroscopy. MAIN OUTCOME MEASURES: To evaluate the success and complications of this new laser technique. RESULTS: (1) Thirteen patients conceived; 10 delivered a live infant at term; (2) 87% of the postoperative pregnancies were considered successful as compared with 11% preoperative; (3) complications included a small perforation of the uterus (no treatment needed) and development of uterine adhesions (1 case only). CONCLUSIONS: Hysteroscopic metroplasty with the Nd-YAG laser is a valuable alternative new technique for the treatment of uterine septum.

Abortion, Spontaneous↗
PubMed1992

Hysteroscopic surgery.

Because a wide variety of conditions can be diagnosed hysteroscopically, hysteroscopy has become a diagnostic gold standard. Through "operative" hysteroscopes, both the electrical current of the resectoscope and the energy of the neodymium:yttrium-aluminum-garnet laser have been effective tools in many cases and presented a new alternative to laparotomy and hysterectomy. The most frequent procedures are 1) endometrial ablation and partial endometrial ablation, 2) myomectomy for submucous myomas, 3) two-step myomectomy for large submucosal and intramural myomas, 4) hysteroscopic management of müllerian defects, and 5) hysteroscopic management of intrauterine adhesions.

Electrosurgery↗
PubMed1990

[Hysteroscopic semeiotics of cancer of the uterine body].

Hysteroscopic features of preinvasive and invasive uterine cancer as well as the adjacent endometrium were studied in 103 patients. The following types of early cancer were identified with regard to pattern of growth: a single lesion, multiple lesions and diffuse involvement of the endometrium. On the basis of hysteroscopic signs, tumors were classified into polypoid, plaque-shaped, cystic mucin-producing forms and tumors with predominant atypical vasculature. Clinically apparent endometrial tumors were hysteroscopically classified as circumscribed and diffuse. The former were further subdivided into nodular, polypoid, papillary and cystic mucin-producing patterns. The credibility of hysteroscopic diagnosis was 81.8% for preinvasive and 100%--for invasive uterine carcinoma. Hysteroscopy proved instrumental in uterine cancer diagnosis, particularly, for the preinvasive form since it allows aiming sampling for histological examination to be carried out.

Adult↗
PubMed1989

Hysteroscopy with selective endometrial sampling compared with D&C for abnormal uterine bleeding: the value of a negative hysteroscopic view.

Hysteroscopic evaluation of 187 patients with abnormal uterine bleeding is reviewed. One hundred fifty-one patients had recent tissue sampling by a blind method. The hysteroscope with selected endometrial sampling was more accurate in 9.1% and less accurate in only 0.5% of patients. The specificity of both techniques with selected biopsies was 100%, but the sensitivity of hysteroscopy was greater (98%) than that of D&C (65%). Endometritis was the only condition missed by hysteroscopic viewing and selected biopsy. Those lesions missed by blind tissue sampling were uterine fibroids and endometrial polyps. Among 91 patients whose hysteroscopic view was negative, an abnormality was identified by tissue sampling in only one patient with endometritis.

Adult↗
PubMed1989

Hysteroscopic metroplasty: six years' experience.

Seventy patients who underwent hysteroscopic metroplasty for uterine septa during a 6-year period were reviewed for subsequent gynecologic problems and obstetric outcome. Complete follow-up was obtained for 1 year in 60 patients and through the first pregnancy in 64. The 70 patients were divided into three groups based on obstetric history prior to surgery: 1) 40 with only first-trimester losses, 2) 15 whose histories included second-trimester losses or premature delivery, and 3) 15 with primary infertility. Long-term follow-up indicated no significant gynecologic abnormalities. Comparison of preoperative and postoperative obstetric outcomes indicated the following: 1) Hysteroscopic metroplasty was very effective in treating patients with septa and a history of first-trimester abortion; 2) patients with first-trimester loss and either second-trimester abortion or preterm birth benefited from metroplasty but were still at risk for preterm labor; and 3) hysteroscopic metroplasty does not "cure" unexplained infertility. When compared with abdominal metroplasty for efficacy, morbidity, and cost, hysteroscopic metroplasty appears to be the treatment of choice in patients with uterine septa associated with pregnancy loss. Those patients with a history of second-trimester loss and third-trimester preterm delivery continue to require close monitoring in subsequent pregnancies.

Abortion, Spontaneous↗
PubMedDate not supplied

Hysteroscopic treatment of uterine septa.

Patients with septate uterus usually undergo reproductive failures with recurrent abortions and premature deliveries. Up till now surgical therapy for such a defect has relied on different abdominal metroplasty procedures reflecting the need to establish normal anatomy and physiology of the uterus. Nowadays, wide experience accumulated in hysteroscopic management of intrauterine adhesions, has allowed the incision of the uterine septa with the hysteroscopic technique. In this report the Authors describe the surgical technique of the hysteroscopic metroplasty in eleven cases. Initial results are encouraging: surgical outcome is good, with no intra- or postoperative morbidity; if the pregnancy outcome rate confirms these results, then the traditional abdominal surgical approach should become an out-moded therapy, so making hysteroscopic metroplasty the treatment of choice for the uterine septa.

Abortion, Spontaneous↗
PubMed1991

Re-examination of the anatomic indications for hysteroscopic metroplasty.

Until now the indication for hysteroscopic metroplasty has been based on laparoscopic findings and thus depended on the operator's experience. Using ultrasound and magnetic resonance images of double uteri it should be possible to find more objective indications for this operation. When three points are identified on longitudinal scans of the uterine fundus, the two tubal ostia and the mid-point of the fundal perimetrium, hysteroscopic metroplasty is indicated only in uteri in which the third point is at least 5 mm above a straight line drawn between the tubal ostia. This classification criterion includes more cases than laparoscopic criteria in this study; we performed hysteroscopic metroplasty in 23 double uteri and had we followed the laparoscopic criteria the operation would have been performed only in 19.

Diagnosis, Differential↗
PubMed1988

Therapeutic hysteroscopic procedures.

Hysteroscopy has evolved from a diagnostic procedure into a therapeutic method for a variety of conditions. Instruments specifically designed for hysteroscopic operative procedures have improved. The indications for therapeutic hysteroscopy are increasing and its proper applications can improve patient's gynecologic care. These facts should stimulate the gynecologist to become proficient with hysteroscopy for diagnosis and the treatment of many intrauterine abnormalities. In selected patients there are major advantages including the avoidance of a laparotomy with the potential sequelae that can follow operations requiring entrance into the peritoneal cavity. The operative techniques have been refined and, with experience, good postoperative results and low morbidity have become evident. The septate uterus can be treated by hysteroscopic metroplasty with improved reproductive outcome. Symptomatic submucous myomas in selected patients can be removed hysteroscopically. Lysis of intrauterine adhesions has become the standard method of therapy. Foreign bodies lost in the uterine cavity or embedded IUDs can be removed atraumatically under direct vision. As the approach to intrauterine problems is refined, other applications are being investigated such as tubal cannulation, endoscopic chorionic villus sampling, and application of hysteroscopy to new reproductive technologies such as the placement of gametes in the fallopian tubes. Because of the simplicity of approaching the uterotubal ostia transcervically, hysteroscopy remains in the front line of investigation as a possible approach for inducing tubal occlusion as a permanent or temporary method of contraception. Finally, laser energy is being used in patients with intractable uterine bleeding to photocoagulate the endometrium and to create amenorrhea by means of inducing severe intrauterine adhesions.

Chorionic Villi↗
PubMed1991

Hysteroscopic gamete intra-fallopian transfer: a good alternative, in selected cases, to laparoscopic intra-fallopian transfer.

Results obtained in two groups of patients treated with gamete intra-Fallopian transfer (GIFT) are reported. Hysteroscopic GIFT was carried out in some cases where general anaesthesia was not advisable or possible, i.e. difficulties in tubal catheterization due to pelvic adhesions, extended distal tubal damage, patients' intolerance, lack of available operating theatre. Ovarian stimulation was started on 131 patients for a total of 147 cycles. Twenty-five cycles were cancelled because of failure of the ovarian response. Either laparoscopic (group 1; 73 patients) or hysteroscopic GIFT (group 2; 50 patients) was performed. In group 1 a mean of 6.8 +/- 3.4 oocytes per cycle were retrieved and a mean of 4.7 +/- 1.3 mature oocytes were transferred. The pregnancy rate was 30.1% per retrieval (22 clinical pregnancies). In group 2, a mean of 5.0 +/- 3.1 oocytes was harvested and 3.9 +/- 2.0 mature oocytes per cycle were transferred. Thirteen clinical pregnancies were achieved (26.5% per cycle) in group 2. Comparing the two groups, the number of recovered and transferred oocytes was significantly lower in hysteroscopic GIFT (P less than 0.05 and P less than 0.001 respectively).

Adult↗
PubMed1992

Hysteroscopic endometrial ablation using the rollerball electrode.

OBJECTIVE: To assess the efficacy of hysteroscopic endometrial ablation with the rollerball resectoscope. METHODS: From April 1989 to March 1991, 64 women underwent hysteroscopic endometrial ablation using electrosurgery. Telephone follow-up was obtained for 61 patients at least 6 months after the procedure. The majority of patients requested endometrial ablation because of irregular heavy menses, and two patients presented with postmenopausal bleeding. All patients had preoperative endometrial sampling that demonstrated benign endometrial histology. Five women had previous endometrial ablation with the Nd:YAG laser, with persistent bleeding. Eight patients had endometrial polyps and six had submucous fibroids that were resected at the time of hysteroscopic ablation. RESULTS: The average operative time was 31.6 minutes, and an average of 304 mL of distending medium was absorbed during the procedure. Complications included one uterine perforation in a patient who had a previous Nd:YAG ablation, and one epidural anesthetic complication. At follow-up, 18 women (29.5%) reported amenorrhea, 16 (26.2%) reported spotting, 21 (34.4%) reported decreased menstrual flow, four (6.6%) had no change, and two (3.3%) noted increased flow. Subjectively, 49 patients (80.3%) reported a satisfactory outcome. Of the 12 who were not satisfied, seven underwent a repeat ablation with satisfactory results, four chose hysterectomy, and one elected not to have further therapy. CONCLUSION: Endometrial ablation with the rollerball electrode is a safe, excellent method of management in women with excessive menstrual flow and provides a cost-effective, minimally invasive alternative to hysterectomy.

Adult↗
PubMed1992

Uterine defect in a twin pregnancy with a history of hysteroscopic fundal perforation.

A woman with a history of hysteroscopic resection of a uterine septum complicated by fundal perforation presented with a term twin pregnancy and spontaneous rupture of membranes. At cesarean, a 7-cm defect was present in the uterine fundus; the edges of the defect were scarred and without bleeding, suggesting a chronic process. Women with a history of fundal perforation during hysteroscopic resection of a uterine septum should be counseled regarding the possibility of a chronic defect and its potential implications. As more uterine septa are resected via the hysteroscope, our understanding of potential long-term complications will increase.

Adult↗
PubMed1977

Hysteroscopic sterilization--a routine method?

Our intention was to sterilize 50 women by means of hysteroscopic sterilization, and we were unsuccessful in 60% of these cases. All these women ran the risk of another pregnancy with hysteroscopic sterilization alone. Therefore--in our opinion--the method of hysteroscopic sterilization by thermocoagulation of the intramural part of the tubes is not yet a routine method, at least not before another modification of this method or instruments makes it possible to obtain better results.

Endoscopy↗
PubMed1990

[Clinico-hysteroscopic characteristics of chronic endometritis].

Clinical presentations of chronic endometritis have been compared with hysteroscopic findings in 60 women of reproductive age. Clinical and hysteroscopic data were indicative of a close correlation of gross endometrial abnormalities with certain symptoms of chronic endometritis and of severity and pattern of mucosal lesions of the corpus mucosa. Elucidation of clinical and hysteroscopic features of chronic endometritis permits a differential approach to the management of these patients.

Adult↗