Hysteroscopy in patients with repeated implantation failure improves the outcome of assisted reproductive technology in fresh and frozen cycles

Journal of Obstetrics and Gynaecology Research - Tập 40 Số 5 - Trang 1324-1330 - 2014
Marzieh Agha Hosseini1, Nasim Ebrahimi1, Atossa Mahdavi1, Ashraf Aleyasin1, Leili Safdarian1, Parvin Fallahi1, Fatemeh Esfahani1
1Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

Tóm tắt

AbstractAimRepeated implantation failure (RIF) is still a problem for many patients and their physicians. Some interventions have been practiced to overcome the problem; one is uterine cavity assessment before assisted reproductive technology (ART) cycles. This study aimed to evaluate the effect of hysteroscopy in women experiencing recurrent implantation failure with apparently normal uterine cavity before assisted reproductive techniques.Material and MethodsThis was a cohort study with historical controls conducted in a university hospital. A total of 353 women with RIF undergoing ART with normal hysterosalpingography and transvaginal ultrasound were evaluated. The intervention group underwent hysteroscopy with a rigid, 30°, 4‐mm hysteroscope in the menstrual cycle just before ART; in the control group hysteroscopy was not performed. Basal characteristics, stimulation parameters and pregnancy rates were compared between the two groups.ResultsChemical pregnancy occurred in 58.5% of women in the hysteroscopy group versus 34.1% of control women (odds ratio [OR]: 2.7; 95% confidence interval [CI]: 1.7–4.2; P < 0.001). Clinical pregnancy occurred in 50.7% and 30.3% of women in the hysteroscopy and control groups, respectively (OR: 2.4; 95%CI: 1.5–3.7; P < 0.001). Delivery rate was 35.5% in hysteroscopy women and 21.1% in control women (OR: 1.9; 95%CI: 1.2–3.1; P = 0.008). The results of hysteroscopy were normal in 103 women (72.5%), and they revealed inflammation in 22 (15.5%), polyp in 16 (11.3%) and Asherman syndrome in one patient (0.7%).ConclusionsHysteroscopy in the menstrual cycle before ovarian stimulation in fresh cycles and before endometrial preparation in frozen thawed cycles in women experiencing recurrent implantation failure with apparently normal uterine cavity significantly increases the pregnancy rates in fresh and frozen cycles, respectively.

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Tài liệu tham khảo

10.5005/jp-journals-10016-1009

10.1016/S1472-6483(10)60846-2

10.1093/humrep/del305

10.2217/whe.10.61

Sakkas D, 2009, Textbook of Assisted Reproductive Technologies, Laboratory and Clinical Perspectives, 243

Rao AK, 2006, Laboratory Manual in Assisted Reproductive Technology

10.1016/S1472-6483(10)60486-5

10.1016/j.fertnstert.2003.05.003

10.1016/j.fertnstert.2010.06.033

10.1016/S1472-6483(10)61108-X

Makrakis E, 2010, The outcomes of hysteroscopy in women with implantation failures after in‐vitro fertilization: Findings and effect on subsequent pregnancy rates, Curr Opin Obstet Gynecol, 22, 339, 10.1097/GCO.0b013e32833beaa3

10.1093/humrep/17.5.1149

10.1016/S0015-0282(03)00345-5

10.1016/j.fertnstert.2006.05.062

10.1093/humrep/15.9.1943

10.1016/j.fertnstert.2007.05.064

El‐Toukhy T, 2009, A multi‐centre randomised controlled study of pre‐IVF outpatient hysteroscopy in women with recurrent IVF implantation failure: Trial of Outpatient Hysteroscopy [TROPHY] in IVF, Reprod Health, 3, 225

10.1093/humrep/15.3.723

Zayed M, 2002, Routine office microhysteroscopy using the vaginoscopic approach in patients prepared for in vitro fertilisation or intrauterine insemination, Middle East Fertil Soc J, 7, 225

10.1016/j.jmig.2011.09.003

10.1016/j.fertnstert.2008.02.135

10.1007/s10815-007-9196-8

10.1007/s00404-011-1866-1

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Thông tin xuất bản

Journal of Obstetrics and Gynaecology Research

Tập 40 Số 5

1324-1330

Thông tin tác giả