Hysteroscopy as an investigation tool in recurrent implantation failure in vitro fertilization

Abstract

Objectives:To evaluate the use of hysteroscopy in the assessment of uterine pathologies in infertile women with repeated implantation failure (RIF) after in vitro fertilization (IVF) and determine whether removal of such pathologies increased pregnancy rates in women with RIF.Methods:This prospective study was conducted at King Fahd Hospital of the University, Al-Khobar, Kingdom of Saudi Arabia, between January 2010 and December 2015. The inclusion criteria were women who underwent IVF treatment cycles and ended in more than 2 RIF, and women who underwent hysterosalpingography (HSG). Hysteroscopies were performed, findings were recorded, and the clinical pregnancy rates were compared and assessed in patients with and without uterine cavity abnormality. All hysteroscopic procedures were performed by a single consultant.Results:Hysteroscopies were performed on 266 women who had at least 2 RIF. The average duration of infertility was 7.2±3.1 years. In 162 patients (60.9%), a hysteroscopy did not find any abnormality of the uterine cavity. In 104 patients (39.1%) there were one or more abnormal hysteroscopic findings. Hysterosalpingography was able to detect only 54 abnormalities (51.9%). The pregnancy rate was significantly higher in patients who were treated by a hysteroscopy for a detected uterine abnormality (39.4%).Conclusion:A hysteroscopy was able to detect intrauterine pathologies which were missed by other investigative modalities. We believe patients with a history of RIF should undergo hysteroscopic examination before any further cycles are considered.

Hysteroscopic Identification of Intrauterine Pathology in Oocyte Donation Cycles: A Retrospective Study

“…Of note, the procedure itself is not without complications [17]. In this study complication rates were about 1% and all of them resolved easily; this is in accordance with the reported incidence of complications of about 1-3% [17].…”

“…With regards to the RIF-DOR group, we identified intrauterine pathology in the 39.5% of the participants, which is in accordance with previously published data concluding that patients with a history of RIF should probably undergo hysteroscopic examination before any further cycles are considered [17].…”

“…Hysteroscopy has proved its value and has now become a usual easy applicable and carried out as an outpatient procedure [4]. Of note, the procedure itself is not without complications [17]. In this study complication rates were about 1% and all of them resolved easily; this is in accordance with the reported incidence of complications of about 1-3% [17].…”

Hysteroscopy with Endometrial Vacuum Aspiration in Repeated Implantation Failure: Diagnostic Significance and the Effect on IVF Success

“…Частота выявления патологии матки у пациенток с RIF в разных исследованиях составляет от 23,4 % до 44,9 %. Так, при изучении структуры патологии матки у пациенток с RIF полип эндометрия встречался в 3,9-35,6 % случаев, миома матки -0,3-15,3 %, спаечный процесс в матке -4,5-22,1 %, пороки развития -2,4-5,7 % случаев [8][9][10][11][12]. Значительный контраст с данными других авторов в вопросе частоты выявления патологии матки на гистероскопии связан с тем, что заключения «эндометриоз матки» и «эндометрит» не включались в отчеты исследователей, хотя имеются данные о связи этих состояний с нарушением процесса имплантации [13][14][15].…”