Effect of Hysteroscopic Surgery Before Frozen Embryo Transfer on Patients with Previous Implantation Failure

Year 2022, , 287 - 292, 30.12.2022

Caglar Cetin , Cihan Çetin , İlay Öztürk , Ayşe Filiz Gokmen Karasu , Abdullah Tok , M.turan Çetin , Dilek Kaya Kaplanoğlu

https://doi.org/10.18678/dtfd.1160553

Abstract

Aim: The aim of this study was to evaluate the benefit of hysteroscopy (HS) before single frozen-thawed embryo transfer (sFET) on patients with previous implantation failure.
Material and Methods: A total of 1352 infertile women with a previous implantation failure who underwent their first sFET treatment between January 2015 and December 2017 were included in this study. The patients were classified into two main groups in which HS was omitted (Group 1), and who underwent HS (Group 2). Furthermore, Group 2 was classified into two subgroups as patients without any intrauterine pathology (Group 2a), and those with intrauterine pathology (Group 2b). sFET was performed on all patients within 50 days of hysteroscopy. The major outcome measure was the clinical pregnancy rate.
Results: The mean number of mature oocytes and fertilization rates were similar between groups. The clinical pregnancy rate was found to be 33.3% (n=70) in Group 1. Comparatively this rate was statistically significantly higher in patients in Group 2. The clinical pregnancy rate was 44.2% (n=378) in Group 2a, and 44.4% (n=127) in Group 2b (p=0.014). There was a significant difference between Group 1 and Group 2a (OR: 1.58, 95% CI: 1.15-2.17, p=0.004), and also Group 2b (OR: 1.59, 95% CI: 1.10-2.31, p=0.013). However, no significant difference was observed between Group 2a and Group 2b (p=0.896).
Conclusion: Our findings demonstrate that HS surgery increases the probability of pregnancy rate at least by 1.58 times in patients having previous implantation failure when the hysteroscopic procedure is followed by sFET.

Keywords

Hysteroscopy, Infertility, Blast, sFET, implantation failure

İmplantasyon Başarısızlığı Olan Hastalarda Donmuş Embriyo Transferi Öncesi Histeroskopik Cerrahinin Etkisi

Abstract

Amaç: Bu çalışmanın amacı, daha önce implantasyon başarısızlığı olan hastalarda tek donmuş çözülmüş embriyo transferi (single frozen-thawed embryo transfer, sFET) öncesi histeroskopinin faydasını değerlendirmektir.
Gereç ve Yöntemler: Bu çalışmaya, Ocak 2015 ile Aralık 2017 tarihleri arasında daha önce bir implantasyon başarısızlığı olan ve ilk kez sFET tedavisi yapılan toplam 1352 infertil kadın dahil edildi. Hastalar HS yapılmayanlar (Grup 1) ve HS uygulananlar (Grup 2) olmak üzere iki ana gruba ayrıldı. Ayrıca, Grup 2, intrauterin patolojisi olmayan hastalar (Grup 2a) ve intrauterin patolojisi olanlar (Grup 2b) olmak üzere iki alt gruba ayrıldı. Tüm hastalara histeroskopi prosedüründen sonraki 50 gün içinde sFET uygulandı. Ana sonuç ölçütü klinik gebelik oranları idi.
Bulgular: Ortalama olgun oosit sayısı ve fertilizasyon oranları gruplar arasında benzerdi. Grup 1’de klinik gebelik oranı %33,3 (n=70) olarak bulundu. Karşılaştırıldığında bu oran Grup 2’deki hastalarda istatistiksel olarak anlamlı şekilde daha yüksekti. Klinik gebelik oranı, Grup 2a’da %44,2 (n=378) ve Grup 2b’de ise %44,4 (n=127) idi (p=0,014). Grup 1 ile Grup 2a arasında (OR: 1,58; %95 GA: 1,15-2,17; p=0,004) ve aynı zamanda Grup 1 ile Grup 2b arasında (OR: 1,59; %95 GA: 1,10-2,31; p=0,013) istatistiksel olarak anlamlı fark vardı. Ancak Grup 2a ve Grup 2b arasında anlamlı bir fark gözlenmedi (p=0,896).
Sonuç: Bulgularımız, histeroskopik prosedürü sFET ile takip edildiğinde, daha önce implantasyon başarısızlığı olan hastalarda HS cerrahisinin gebelik olasılığını en az 1,58 kat artırdığını göstermektedir.

Keywords

İnfertilite, Histeroskopi, Blast, sFET, implantasyon başarısızlığı

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