Dear Professor Winston,
My partner and I have been diagnosed with unexplained infertility. We have been trying to conceive naturally for over 3 years and have one failed cycle of IVF. We had 4 blastocysts out of 4 fertilised eggs ( 1 transferred 2 frozen ) so i do not believe that the quality of our embryos is an issue. I have had heavy periods throughout my life and always pass at least 10 large clots each cycle. Could this be an issue? I have had a HyCoSy but i am now thinking i should have a hysteroscopy. What are the success rates of a hysteroscopy and do you think i should pursue this option? Many Thanks for your help. S
Dear S,
In my view a hysterosalpingogram done with a little radio-opaque dye is likely to be much more informative and is also cheaper. Also an endometrial biopsy, which can be done without an anaesthetic should be considered. I have said many times on this website that HyCoSy, though very widely used, is not very informative. I would also like to know that you are having really careful assessment of your hormonal status.
Hysteroscopy will miss adenomyosis almost certainly and it is surprising often that fibroids are not diagnosed either using the hysteroscope. Given that you say you have unexplained infertility, I take it you’ve had a laparoscopy?
Best wishes
Robert Winston