DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20170392

Office hysteroscopy prior to ART cycle-analysis and outcome at a private IVF clinic setup in Surat, Gujarat, India

Meeta Mohan Mahale, Purnima Kishore Nadkarni, Kishore Mohan Nadkarni, Pooja Prabhakar Singh, Aditi Akshay Nadkarni, Prabhakar Mahendra Singh

Abstract


Background: Hysteroscopy is a gold standard test for assessing the uterine cavity. The presence of uterine pathology may negatively affect the chance of implantation .This study investigated the use of routine office hysteroscopy and correction of any intrauterine pathologies prior to starting IVF cycle on treatment outcome in women seeking IVF treatment for primary infertility and recurrent implantation failure.

Methods: This was a retrospective study of 100 women who attended our infertility clinic from July 2016 to December 2016 and who were willing for office hysteroscopy. The main outcomes measured were clinical pregnancy rates achieved in the index IVF cycle, multiple pregnancy rate, ectopic pregnancy rate, miscarriage rate and failure rate.

Results: Of the 100 patients who participated in the study, 75 patients conceived, 25 patients failed to conceive. 80.64% patients with normal findings on diagnostic hysteroscopy conceived after the procedure, 58.33% patients conceived after polypectomy, 68.42% conceived after septal resection, 71.42% conceived after adhesiolysis, 50% conceived after lateral metroplasty and 73.07% of recurrent implantation failure conceived after local endometrial injury was done on hysteroscopy.

Conclusions: Hysteroscopy in infertile women prior to their IVF cycle when performed atleast 3 months in advance could improve treatment outcome.

Keywords


Hysteroscopy, ICSI, Pregnancy rate

Full Text:

PDF

References


Bouwmans CA, Lintsen BM, Eijkemans MJ, Habbema JD, Braat DD, Hakkaart L. A detailed cost analysis of in vitro fertilization and intracytoplasmic sperm injection treatment. Fertil Steril. 2008;89(2):331-41.

Verhaak C, Smeenk J, Evers A, Kremer J, Kraaimaat F, Braat D:Women's emotional adjustment to IVF: a systematic review of 25 years of research. Human Reproductive Update. 2007;13:27-36.

Urman B, Yakin K, Balaban B: Recurrent implantation failure in assisted reproduction: how to counsel and manage. A. General considerations and treatment options that may benefit the couple. Reproductive BioMedicine Online. 2005;11:371-81.

Kirsop R, Porter R, Torode H, Smith D, Saunders D. The role of hysteroscopy in patients having failed IVF/GIFT transfer cycles. Australian and New Zealand Journal of Obstetrics and Gynaecology. 1991;31:263-4.

Bosteels J, Weyers S. 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.

El Toukhy T, Sunkara SK, Coomarasamy A, Grace J, Khalaf Y. Outpatient hysteroscopy and subsequent IVF cycle outcome: A systematic review and meta analysis. Reprod Biomed Online. 2008;16:712-9.

Faghali J, Bakar J, Mayenga JM, S├ęgard L, Hamou J, Driguez P, et al. Systematic hysteroscopy prior to In vitro fertilisation. Gynecol Obstet Fertil. 2003;31:127-3.

De Placido, G., Clarizia, R., Cadente, C., Castaldo, G., Romano, C.,Mollo,et al. Compliance and diagnostic efficacy of mini-hysteroscopy versus traditional hysteroscopy in infertility investigation. Eur J Obstet Gynecol Reprod Biol. 2007;135:83-7.

El-Mazny A, Abou-Salem N, El-Sherbiny W, Saber W: Outpatient hysteroscopy: a routine investigation before assisted reproductive techniques? Fertil Steril. 2011;95(1):272-6.

10.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(4):339-43.

Dhulkotia J, Coughlan C. Effect of endometrial injury on subsequent pregnancy rates in women undergoing IVF after previous implantation failure: systematic review and meta-analysis. BJOG. 2012;119:132-3.

Karayalcin R, Ozcan S. Results of 2500 office-based diagnostic hysteroscopies before IVF. Reproductive BioMedicine Online. 2010;20(5):689-93.

Karayalcin R, Ozcan S. Office hysteroscopy improves pregnancy rates following IVF. Reproductive BioMedicine Online. 2012;25(3):261-6.

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.

Tomazevic T, Ban-Frangez H. Septate, subseptate and arcuate uterus decrease pregnancy and live birth rates in IVF/ICSI. Reproductive Bio Medicine Online. 2010;21(5):700-5.

El-Toukhy T, Campo R. Hysteroscopy in recurrent in-vitro fertilisation failure (TROPHY): a multicentre, randomised controlled trial. The Lancet Choice. 2016;387:2614-21.

Spiezio Sardo AD, Di Carlo C. Efficacy of hysteroscopy in improving reproductive outcomes of infertile couples: a systematic review and meta-analysis. Hum Reprod Update. 2016;22(4):479-96.