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

Year 2016, Volume: 2 Issue: 3, 182 - 187, 04.11.2016
https://doi.org/10.18621/eurj.2016.5000185919

Abstract

Objective. This study aims to evaluate the importance of performing hysteroscopy prior to the first attempt of in vitro fertilization (IVF) or intracytoplasmic sperm injection (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 (n=101), male factor (n=84), tubal factor (n=78) and unexplained infertility (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 (13.7%), submucous myomas (5.9%), uterine septa (4.5%), endometrial adhesions (3.1%), endometritis (1.4%) and cervical stenosis (0.8%). When compared to the women with normal hysteroscopy (n=252), the women with corrected hysteroscopic abnormalities (n=105) had significantly higher fertilization rate (p=0.045), implantation rate (p=0.038), clinical pregnancy rate (p=0.022) and live birth rate (p=0.022). When compared to the women with normal transvaginal ultrasonography and hysteroscopy findings (n=252), the women with normal ultrasonography and abnormal hysteroscopy (n=35) had significantly higher implantation rate (p=0.044), clinical pregnancy rate (p=0.032) and live birth rate (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. 

References

  • Coughlan C, Ledger W, Wang Q, Liu F, Demirol A, Gurgan T, et al. Recurrent implantation failure: definition and management. Reprod Biomed Online 2014;28:14-38.
  • Timeva T, Shterev A, Kyurkchirev S. Recurrent implantation failure: the role of the endometrium. J Reprod Infertil 2014;15:173-83.
  • Fatemi HM, Popovic-Todorovic B. Implantation in assisted reproduction: a look at endometrial receptivity. Reprod Biomed Online 2013;27:530-8.
  • Moini A, Kiani K, Ghaffari F, Hosseini F. Hysteroscopic findings in patients with a history of two implantation failures following in vitro fertilization. Int J Fertil Steril 2012;6:27-30.
  • Cenksoy P, Ficicioglu C, Yildirim G, Yesiladali M. Hysteroscopic findings in women with recurrent IVF failures and the effect of correction of hysteroscopic findings on subsequent pregnancy rates. Arch Gynecol Obstet 2013;287:357-60.
  • Pundir J, El Toukhy T. Uterine cavity assessment prior to IVF. Womens Health (Lond) 2010;6:841-7; quiz 847-8.
  • Papathanasiou A, Bhattacharya S. Prognostic factors for IVF success: diagnostic testing and evidence-based interventions. Semin Reprod Med 2015;33:65-76.
  • Bosteels J, Weyers S, Puttemans P, Panayotidis C, Van Herendael B, Gomel V, et al. The effectiveness of hysteroscopy in improving pregnancy rates in subfertile women without other gynaecological symptoms: a systematic review. Hum Reprod Update 2010;16:1-11.
  • Bettocchi S, Achilarre MT, Ceci O, Luigi S. Fertility-enhancing hysteroscopic surgery. Semin Reprod Med 2011;29:75-82.
  • Bosteels J, Kasius J, Weyers S, Broekmans FJ, Mol BW, D’Hooghe TM. Hysteroscopy for treating subfertility associated with suspected major uterine cavity abnormalities. Cochrane Database Syst Rev 2015;2:CD009461.
  • Makrakis E, Pantos K. The outcomes of hysteroscopy in women with implantation failures after in-vitro fertilization: findings and effect on subsequent pregnancy rates. Curr Opin Obstet Gynecol 2010;22:339-43.
  • Pundir J, Pundir V, Omanwa K, Khalaf Y, El-Toukhy T. Hysteroscopy prior to the first IVF cycle: a systematic review and meta-analysis. Reprod Biomed Online 2014;28:151-61.
  • Coughlan C, Ledger W, Wang Q, Liu F, Demirol A, Gurgan T, et al. Recurrent implantation failure: definition and management. Reprod Biomed Online 2014;28:14-38.
  • Vlachadis N, Vrachnis N, Economou E, Siristatidis C. Zooming in on the definition of “recurrent implantation failure”. Reprod Biomed Online 2014;29:144-5.
  • Evans-Hoeker EA, Young SL. Endometrial receptivity and intrauterine adhesive disease. Semin Reprod Med 2014;32:392-401.
  • Campo S, Campo V, Benagiano G. Adenomyosis and infertility. Reprod Biomed Online 2012;24:35-46.
  • Crosignani PG, Rubin BL. Optimal use of infertility diagnostic tests and treatments: The ESHRE Capri Workshop Group. Hum Reprod 2000;15:723-32.
  • Shokeir TA, Shalan HM, EI Shafei MN. Significance of endometrial polyps detected hysteroscopically in eumenorrheic infertile women. J Obstet Gynecol 2004;30:84-9.
  • Fatemi HM, Kasius JC, Timmermans A, van Disseldorp J, Fauser BC, Devroey P, et al. Prevalence of unsuspected uterine cavity abnormalities diagnosed by office hysteroscopy prior to in vitro fertilization. Hum Reprod 2010;25:1959-65.
  • Yu HT, Wang CJ, Lee CL, Huang HY, Chen CK, Wang HS. The role of diagnostic hysteroscopy before the first in vitro fertilization/intracytoplasmic sperm injection cycle. Arch Gynecol Obstet 2012;286:1323-8.
  • Di Spiezio Sardo A, Di Carlo C, Minozzi S, Spinelli M, Pistotti V, Alviggi C, et al. Efficacy of hysteroscopy in improving reproductive outcomes of infertile couples: a systematic review and meta-analysis. Hum Reprod Update 2016;22:479-96.
Year 2016, Volume: 2 Issue: 3, 182 - 187, 04.11.2016
https://doi.org/10.18621/eurj.2016.5000185919

Abstract

References

  • Coughlan C, Ledger W, Wang Q, Liu F, Demirol A, Gurgan T, et al. Recurrent implantation failure: definition and management. Reprod Biomed Online 2014;28:14-38.
  • Timeva T, Shterev A, Kyurkchirev S. Recurrent implantation failure: the role of the endometrium. J Reprod Infertil 2014;15:173-83.
  • Fatemi HM, Popovic-Todorovic B. Implantation in assisted reproduction: a look at endometrial receptivity. Reprod Biomed Online 2013;27:530-8.
  • Moini A, Kiani K, Ghaffari F, Hosseini F. Hysteroscopic findings in patients with a history of two implantation failures following in vitro fertilization. Int J Fertil Steril 2012;6:27-30.
  • Cenksoy P, Ficicioglu C, Yildirim G, Yesiladali M. Hysteroscopic findings in women with recurrent IVF failures and the effect of correction of hysteroscopic findings on subsequent pregnancy rates. Arch Gynecol Obstet 2013;287:357-60.
  • Pundir J, El Toukhy T. Uterine cavity assessment prior to IVF. Womens Health (Lond) 2010;6:841-7; quiz 847-8.
  • Papathanasiou A, Bhattacharya S. Prognostic factors for IVF success: diagnostic testing and evidence-based interventions. Semin Reprod Med 2015;33:65-76.
  • Bosteels J, Weyers S, Puttemans P, Panayotidis C, Van Herendael B, Gomel V, et al. The effectiveness of hysteroscopy in improving pregnancy rates in subfertile women without other gynaecological symptoms: a systematic review. Hum Reprod Update 2010;16:1-11.
  • Bettocchi S, Achilarre MT, Ceci O, Luigi S. Fertility-enhancing hysteroscopic surgery. Semin Reprod Med 2011;29:75-82.
  • Bosteels J, Kasius J, Weyers S, Broekmans FJ, Mol BW, D’Hooghe TM. Hysteroscopy for treating subfertility associated with suspected major uterine cavity abnormalities. Cochrane Database Syst Rev 2015;2:CD009461.
  • Makrakis E, Pantos K. The outcomes of hysteroscopy in women with implantation failures after in-vitro fertilization: findings and effect on subsequent pregnancy rates. Curr Opin Obstet Gynecol 2010;22:339-43.
  • Pundir J, Pundir V, Omanwa K, Khalaf Y, El-Toukhy T. Hysteroscopy prior to the first IVF cycle: a systematic review and meta-analysis. Reprod Biomed Online 2014;28:151-61.
  • Coughlan C, Ledger W, Wang Q, Liu F, Demirol A, Gurgan T, et al. Recurrent implantation failure: definition and management. Reprod Biomed Online 2014;28:14-38.
  • Vlachadis N, Vrachnis N, Economou E, Siristatidis C. Zooming in on the definition of “recurrent implantation failure”. Reprod Biomed Online 2014;29:144-5.
  • Evans-Hoeker EA, Young SL. Endometrial receptivity and intrauterine adhesive disease. Semin Reprod Med 2014;32:392-401.
  • Campo S, Campo V, Benagiano G. Adenomyosis and infertility. Reprod Biomed Online 2012;24:35-46.
  • Crosignani PG, Rubin BL. Optimal use of infertility diagnostic tests and treatments: The ESHRE Capri Workshop Group. Hum Reprod 2000;15:723-32.
  • Shokeir TA, Shalan HM, EI Shafei MN. Significance of endometrial polyps detected hysteroscopically in eumenorrheic infertile women. J Obstet Gynecol 2004;30:84-9.
  • Fatemi HM, Kasius JC, Timmermans A, van Disseldorp J, Fauser BC, Devroey P, et al. Prevalence of unsuspected uterine cavity abnormalities diagnosed by office hysteroscopy prior to in vitro fertilization. Hum Reprod 2010;25:1959-65.
  • Yu HT, Wang CJ, Lee CL, Huang HY, Chen CK, Wang HS. The role of diagnostic hysteroscopy before the first in vitro fertilization/intracytoplasmic sperm injection cycle. Arch Gynecol Obstet 2012;286:1323-8.
  • Di Spiezio Sardo A, Di Carlo C, Minozzi S, Spinelli M, Pistotti V, Alviggi C, et al. Efficacy of hysteroscopy in improving reproductive outcomes of infertile couples: a systematic review and meta-analysis. Hum Reprod Update 2016;22:479-96.
There are 21 citations in total.

Details

Primary Language English
Subjects Obstetrics and Gynaecology
Journal Section Original Articles
Authors

Safak Hatirnaz

Mine Kanat Pektas

Alev Ozer This is me

Ebru Saynur Hatirnaz This is me

Publication Date November 4, 2016
Submission Date April 18, 2016
Acceptance Date June 18, 2016
Published in Issue Year 2016 Volume: 2 Issue: 3

Cite

AMA Hatirnaz S, Pektas MK, Ozer A, Saynur Hatirnaz E. Hysteroscopy before the first in vitro fertilization: a 7-year experience from a single center. Eur Res J. November 2016;2(3):182-187. doi:10.18621/eurj.2016.5000185919

e-ISSN: 2149-3189 


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