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Geburtshilfe Frauenheilkd 2005; 65(2): 139-143
DOI: 10.1055/s-2004-830428
Übersicht

Georg Thieme Verlag KG Stuttgart · New York

Zum Stellenwert der Hysteroskopie als Screeningmethode in der Sterilitätsdiagnostik

The Importance of Hysteroscopy As a Screening Method in the Diagnosis of SterilityF. Nawroth1 , T. Schmidt2 , D. Foth2
  • 1Endokrinologikum Hamburg, Zentrum für Hormon- und Stoffwechselerkrankungen, Reproduktionsmedizin und Gynäkologische Endokrinologie, Hamburg
  • 2Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum der Universität zu Köln
Weitere Informationen

Publikationsverlauf

Eingang Manuskript: 1.7.2004 Eingang revidiertes Manuskript: 4.10.2004

Akzeptiert: 6.10.2004

Publikationsdatum:
02. März 2005 (online)

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Zusammenfassung

Die Implantation bzw. ihr Ausbleiben werden multifaktoriell beeinflusst. Ein gesicherter anatomischer Einflussfaktor ist das Cavum uteri. Seit langem wird von einigen Autoren vor der Durchführung von Maßnahmen der assistierten Reproduktion eine Basishysteroskopie gefordert. In der Praxis hat sich dieses Konzept jedoch bisher nicht umfassend durchgesetzt.

Die ambulante Minihysteroskopie ermöglicht eine schnelle und direkte Betrachtung des Cavum uteri ohne Anästhesie und wird von den Patientinnen gut toleriert. Pro und Contra der ambulanten Minihysteroskopie im Rahmen der Sterilitätsdiagnostik werden anhand der aktuellen Literatur und eigener Daten diskutiert. Die Vaginalsonographie kann in der Diagnostik intrakavitärer Pathologien die Hysteroskopie nicht ersetzen.

Wir empfehlen die Durchführung einer Minihysteroskopie vor jeder Sterilitätstherapie, um potenziell negative Einflüsse einer intrauterinen Pathologie auf die Implantation oder die Abortrate auszuschließen. Dieses Konzept muss in weiteren Studien kritisch überprüft werden.

Abstract

Implantation or implantation failure are influenced by different factors. One of the well known anatomic factors involved is the uterine cavity. Outpatient mini-hysteroscopy allows fast and direct evaluation of the uterine cavity without anaesthesia. It has long been recommended but has not always been accepted that a basic hysteroscopy should be performed in patients before carrying out assisted reproductive techniques. Transvaginal sonography should be performed at the same time but can not replace hysteroscopy. Available literature and own results are discussed.

In summary, we recommend outpatient mini-hysteroscopy as a screening method before starting assisted reproductive techniques to exclude intrauterine pathologies. This concept needs to be evaluated in further studies.

Schlüsselwörter

Basisdiagnostik - Hysteroskopie - Minihysteroskopie - Sterilität

Key words

Basic diagnostics - hysteroscopy - mini-hysteroscopy - sterility

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Priv.-Doz. Dr. med. Frank Nawroth

Endokrinologikum Hamburg

Lornsenstraße 4 - 6

22767 Hamburg

eMail: Frank.Nawroth@Endokrinologikum.com

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