Hysteroscopy before the first in vitro fertilization: a 7-year experience from a single center

Authors : Safak HATİRNAZ, Mine Kanat PEKTAS, Alev Ozer, Ebru Saynur Hatirnaz

Pages : 182-187

Doi:10.18621/eurj.2016.5000185919

View : 20 | Download : 9

Publication Date : 2016-11-04

Article Type : Research Paper

Abstract :Objective. This study aims to evaluate the importance of performing hysteroscopy prior to the first attempt of in vitro fertilization insert ignore into journalissuearticles values(IVF); or intracytoplasmic sperm injection insert ignore into journalissuearticles values(ICSI); by specifying the incidence of intrauterine pathologies and the success of IVF/ICSI cycle. Methods. This is a retrospective review of 357 women who underwent their first cycle of IVF/ICSI treatment during a 7- year period. All women had primary infertility due to various factors: Polycystic ovary syndrome insert ignore into journalissuearticles values(n=101);, male factor insert ignore into journalissuearticles values(n=84);, tubal factor insert ignore into journalissuearticles values(n=78); and unexplained infertility insert ignore into journalissuearticles values(n=94);. Results. The majority of the patients had normal hysteroscopic findings whereas 29.4% of them had an intrauterine pathology. Abnormal hysteroscopic findings included endometrial polyps insert ignore into journalissuearticles values(13.7%);, submucous myomas insert ignore into journalissuearticles values(5.9%);, uterine septa insert ignore into journalissuearticles values(4.5%);, endometrial adhesions insert ignore into journalissuearticles values(3.1%);, endometritis insert ignore into journalissuearticles values(1.4%); and cervical stenosis insert ignore into journalissuearticles values(0.8%);. When compared to the women with normal hysteroscopy insert ignore into journalissuearticles values(n=252);, the women with corrected hysteroscopic abnormalities insert ignore into journalissuearticles values(n=105); had significantly higher fertilization rate insert ignore into journalissuearticles values( p =0.045);, implantation rate insert ignore into journalissuearticles values( p =0.038);, clinical pregnancy rate insert ignore into journalissuearticles values( p =0.022); and live birth rate insert ignore into journalissuearticles values( p =0.022);. When compared to the women with normal transvaginal ultrasonography and hysteroscopy findings insert ignore into journalissuearticles values(n=252);, the women with normal ultrasonography and abnormal hysteroscopy insert ignore into journalissuearticles values(n=35); had significantly higher implantation rate insert ignore into journalissuearticles values( p =0.044);, clinical pregnancy rate insert ignore into journalissuearticles values( p =0.032); and live birth rate insert ignore into journalissuearticles values( p =0.030);. Conclusion: The utilization of hysteroscopy before the first IVF cycle would allow the detection and treatment of intrauterine pathologies and structural uterine abnormalities that might be responsible for the failure of IVF and, thus, result in improved pregnancy rates. 
Keywords : Hysteroscopy, in vitro fertilization, intracytoplasmic sperm injection, infertility, intrauterine pathology