Hysteroscopy after repeated implantation failure of assisted reproductive technology: A meta‐analysis

Abstract

We conducted this meta-analysis to explore the prognostic value of outpatient (or office) hysteroscopy (OH) preceding in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycles in women who had experienced repeated implantation failure (RIF), particularly in regard to the conflicting evidence reported by previous studies. Two reviewers independently searched Pubmed, MEDLINE, Web of Science, Cochrane Library and Embase to identify all publications of clinical trials of hysteroscopy with or without endometrial biopsy in RIF patients. The primary outcome measures were clinical pregnancy rate (CPR) and live birth rate (LBR). Pooled relative ratios (RRs) with 95% confidence intervals (CIs) were calculated. Publication bias was detected using funnel plots and Egger's regression tests. Six eligible studies comprising 4143 patients were included. The CPR and LBR were both significantly higher in RIF patients with OH than RIF patients without OH (CPR: RR 1.34, 95% CI 1.14-1.57, P < 0.05; LBR: RR 1.29, 95% CI 1.03-1.62, P < 0.05). Subgroup analysis revealed a significant association between OH and CPR in Asia (CPR: RR 1.49, 95% CI 1.31-1.69; P < 0.05) rather than in Europe (CPR: RR 1.08, 95% CI 0.93-1.26; P = 0.291). However, there was no evidence of a significant difference in either CPR or LBR between the normal and abnormal OH groups (CPR: RR 0.92, 95% CI 0.83-1.02, P = 0.12; LBR: RR 0.76, 95% CI 0.37-1.56, P = 0.450). Hysteroscopy may potentially improve pregnancy outcomes in patients with RIP.

Histeroskopi IVF-ICSI/ET öncesi mi, sonrası mı yapılmalıdır?

“…Daha önceki randomize kontrollü çalışmalar, ofis tanısal histeroskopinin tekrarlayan implantasyon başarısızlığı olan hastalar için gebelik oranlarını arttırıcı sonuçlar verdiğine dair kanıt sağlamıştır 14,15 . Bu çalışmada ise ilk kez yapılacak IVF tedavisinden önce tanısal histeroskopi ile değerlendirilen hastaların klinik sonuçları değerlendirildi ve anlamlı fark bulunamadı.…”

Over Ten-Cell Good Embryo Transfers on Day Three have Equivalent Clinical Outcomes with Those of Eight-Cell Embryos in Female Patients Aged ≤35 Years: A Retrospective Cohort Study

“…In recent years, many reports have discussed noninvasive techniques that enable the monitoring of embryos' development without moving them from incubators, using time-lapse imaging, to increase the precision and sensitivity of embryo selection [30][31][32]. Besides the above evaluation criteria, the role of the clinician performing the transfer and the patient's inherent condition (endometrial receptivity) are additional key elements in determining the success of implantation, and should not be ignored [33][34][35][36].…”

The Effect of Hysteroscopy on the Reproductive Outcomes of Infertile Women Without Intrauterine Pathologies: A Systematic Review and Meta-Analysis

“…There are articles and systematic reviews that explore how confirming and treating intrauterine pathologies through hysteroscopy prior to the use of ART can have a positive effect on reproductive outcomes, as intrauterine lesions can negatively affect implantation rates [20][21][22][23][24][25][26][27]. Even in the absence of intrauterine pathological findings, there is literature that examines how performing a hysteroscopy can help improve pregnancy rates through relaxation of the cervix, the triggering of an inflammatory reaction in the endometrium, and the secretion of cytokines [23].…”