Suction curettage versus hysteroscopy for early pregnancy loss after IVF

Comparison Of Surgical Management Of Early Pregnancy Loss By Suction Curettage Versus Hysteroscopy In Patients Undergoing In-Vitro Fertilization (IVF)

This trial will test whether hysteroscopy or suction curettage is better for removing early pregnancy loss in people who conceived with IVF.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 50 (estimated)
• Ages: 18 Years to 50 Years
• Sex: Female
• Sponsor: Assaf-Harofeh Medical Center (other gov)
• Locations: 2 sites (Be’er Ya‘aqov and 1 other locations)
• Trial ID: NCT07143578 on ClinicalTrials.gov

What this trial studies

This interventional study compares operative hysteroscopy using a tissue removal device with conventional suction curettage for evacuation of early pregnancy loss up to 10 weeks in individuals who conceived via IVF. Participants will undergo one of the two surgical procedures and be followed for outcomes such as retained products, bleeding, operative time, and the development of intrauterine adhesions. Hysteroscopy provides direct visualization of the uterine cavity and targeted tissue removal, while suction curettage is performed without direct vision. The trial aims to determine whether hysteroscopy reduces adhesion rates and other complications without causing unacceptable increases in operative time or other risks.

Who should consider this trial

Good fit: Ideal candidates are people with an early pregnancy loss (≤10 weeks) conceived via IVF who can provide informed consent, read Hebrew, and do not have heavy bleeding, signs of infection, uterine anomalies, prior intrauterine adhesions, or disqualifying surgical histories.

Not a fit: Patients with heavy vaginal bleeding or incomplete abortion, suspected infection, known uterine anomalies, prior intrauterine adhesions, a history of ≥3 miscarriages or ≥3 cesarean sections, prior myomectomy, prior treatment for the current pregnancy, or those who did not conceive via IVF are unlikely to benefit or are not eligible.

Why it matters

Potential benefit: If successful, hysteroscopy could reduce intrauterine adhesions and lower the risk of complications that might impair future fertility after early pregnancy loss.

How similar studies have performed: Previous studies, including a randomized trial, showed substantially lower rates of intrauterine adhesions after hysteroscopy compared with suction curettage, although hysteroscopy was associated with longer operative time.

Eligibility criteria

Inclusion Criteria:

1. Diagnosis of early pregnancy loss up to 10 weeks' gestation, based on last menstrual period or ultrasound.
2. Pregnancy conceived through assisted reproductive techniques (in vitro fertilization, IVF).
3. Ability to provide informed consent, and proficiency in reading and writing Hebrew.

Exclusion Criteria:

1. Heavy vaginal bleeding or diagnosis of incomplete abortion.
2. Signs of infection and/or suspicion of septic abortion
3. Known uterine anomalies- including septate, bicornuate, unicornuate, or didelphys uterus.
4. Prior medical or surgical treatment during the current pregnancy
5. History of intrauterine adhesions
6. History of ≥ 3 prior miscarriages.
7. History of ≥ 3 prior cesarean sections.
8. History of myomectomy via abdominal or hysteroscopic approach.

Where this trial is running

Be’er Ya‘aqov and 1 other locations

• Shamir Medical Center — Be’er Ya‘aqov, Israel (RECRUITING)
• Sheba Medical Center, Tel Hashomer — Ramat Gan, Israel (ACTIVE_NOT_RECRUITING)

Study contacts

• Principal investigator: Noam Smorgick, MD — Assaf-Harofeh Medical Center
• Study coordinator: Noam Smorgick, MD

Conditions: Early Abortion, Pregnancy Loss, Early, hysteroscopy, pregnancy loss, early missed abortion, spontaneous abortion, suction curettage, intrauterine adhesions