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
