The effects of hysteroscopy on pregnancy rate before in vitro fertilization-embryo transfer

Torshizi, M. Mansouri; Khalilifar, H.; Naghavizadeh, M.; Bazri, Z.; Mohammadi, F.; Joodi, F.; Anbiaee, S.
June 2014
Iranian Journal of Reproductive Medicine;Jun2014 Supplement, Vol. 12, p8
Academic Journal
Introduction: Recurrent implantation failure (RIF) may be due to unrecognized uterine pathology. Hysterosalpingography, transvaginal ultrasonography, saline infusion sonography and hysteroscopy are the tools to assess the inner architecture of the uterus. Hysteroscopy is considered to be the gold standard; however, the validity of hysteroscopy may be limited in the diagnosis of endometritis and endometrial hyperplasia. We evaluated the ICSI outcome for females who have hysteroscopy before embryo transfer in comparison with groups who have embryo transfer without hysteroscopy. Materials and Methods: This study was performed between 2012 and 2013 in Novin Infertility Treatment Center (Mashhad, Iran).We examined ICSI cycles of 600 patients. For 300 patients embryo transfer was done without hysteroscopy and for 300 patients hysteroscopy was done before embryo transfer. Results: Hysteroscopy finding, implantation rate (IR), clinical and ongoing pregnancy rate (PR) were measured. Fertilization and implantation were similar between the groups. No difference was found regarding the number of transferred embryos (on day 2 or 3) and cryopreserved embryos, multiple pregnancies, abortion rates or transfer's drug protocol between the groups. Pregnancy rate in group that have hysteroscopy before embryo transfer was more than the other group (p=0.05). 36.6% of the study population had abnormal hysteroscopic findings and 22.2% had unsuspected findings. Conclusion: Hysteroscopy in asymptomatic woman prior to their first IVF cycle was found to be associated with improved chance of achieving a subsequent clinical and ongoing pregnancy when performed just before commencing the IVF cycle. Women with 2 implantation failures after IVF had a remarkably high possibility for unsuspected abnormalities on hysteroscopy. The procedure was safe.


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