Abnormal cornual ostia and infertility.

Hysteroscopy performed on 126 infertile patients and on 73 fertile patients revealed a significant association between abnormal uterine cornual ostia and infertility (p less than 0.002). Ostial abnormalities included absence of cupping with uterine cavity distension, diminution of ostial diameter and complete ostial occlusion. High intrauterine pressures from dye perturbation can overcome the occluded ostial state giving a false impression of adequate tubal patency. These findings may explain some cases of apparently unexplained infertility and may bear on the success rates of procedures such as artificial insemination and gamete intrafallopian transfer.