Transcervical placement of a Malecot catheter* after hysteroscopic evaluation provides for easier entry into the endometrial cavity for women with histories of difficult intrauterine inseminations and/or embryo transfers: a prospective case series

Objective: To evaluate a new technique designed to improve access to the en dometrial cavity through tortuous and/or stenotic endocervical canals in wo men with histories of difficult IUIs, ETs, or endometrial biopsies. Design: Prospective case series. Setting: Tertiary care center. Patient(s): Women with histories of difficult intrauterine procedures becau se of tortuous and/or stenotic endocervical canals who continued to undergo treatment. Intervention(s): Hysteroscopic evaluation and/or correction of the endocerv ix, followed by transcervical placement of a Malecot catheter (CR Bard Inc. , Covington, GA) for an average of 10 days. Main Outcome Measure(s): Improvement in the ease of access to the endometri al cavity during IUIs or ETs. Result(s): Thirty-two of 36 patients had significantly easier procedures af ter the placement and removal of a Malecot catheter. Conclusion(s): Hysteroscopic evaluation and placement of a Malecot catheter is a useful technique that allows easier entry through the cervical canal in patients in whom previous IUIs, ETs, and endometrial biopsies have been difficult. This procedure may lead to improved pregnancy rates, particularl y with IVF-ET, as the ease of ET has been correlated with improved implanta tion rates. (Fertil Steril(R) 2000;73:402-5. (C)2000 by American Society fo r Reproductive Medicine.).