Department of Gynecology and Obstetrics, Faculty of Medicine, Yeditepe University, Devlet Yolu Ankara Cad. 102/104, Kozyatagi, Istanbul, Turkey.
Arch Gynecol Obstet. 2013 Feb;287(2):357-60. doi: 10.1007/s00404-012-2627-5. Epub 2012 Nov 27.
Our aim is to evaluate the incidence of unrecognized uterine abnormalities in cases with recurrent IVF failure by screening office hysteroscopy (OH), and impacts of treatment of hysteroscopic findings on the success rate of IVF.
The retrospective and descriptive study was conducted at assisted reproduction unit in a tertiary medical center. One hundred and fifty-seven patients with a history of recurrent IVF failures underwent hysteroscopy between May 2009 and March 2012. Hysteroscopy (diagnostic or operative, as appropriate) was performed to evaluate the endometrial cavity in patients with two or more IVF failures and Incidence of abnormal hysteroscopic findings and the clinical pregnancy rate (CPR) in subsequent IVF cycles were assessed.
In all, 44.9 % of the patients included in this study had abnormal hysteroscopic findings and 75 women (48.1 %) became pregnant following hysteroscopy. Of these pregnancies, 36 occurred in women with corrected endometrial pathology, the majority of which was identified as endometrial polyps. Implantation rate and clinical pregnancy rate were statistically significant increased after polipectomy.
Abnormal findings on hysteroscopy are significantly higher in patients with previous ART failure and hysteroscopy could be seen as a positive prognostic factor for achieving pregnancy in subsequent IVF procedure in women with a history of RIF.
我们的目的是通过筛查门诊宫腔镜(OH)评估复发性体外受精(IVF)失败病例中未被识别的子宫异常的发生率,并评估宫腔镜检查结果对 IVF 成功率的影响。
这是一项在三级医疗中心辅助生殖单位进行的回顾性描述性研究。2009 年 5 月至 2012 年 3 月,157 例复发性 IVF 失败患者接受了宫腔镜检查。对 2 次或 2 次以上 IVF 失败的患者进行宫腔镜检查(诊断性或手术性,视情况而定),评估异常宫腔镜检查结果的发生率和随后 IVF 周期的临床妊娠率(CPR)。
本研究共纳入 44.9%的患者存在异常宫腔镜检查结果,75 名妇女(48.1%)在宫腔镜检查后怀孕。在这些妊娠中,36 例发生在子宫内膜病理纠正的妇女中,其中大多数为子宫内膜息肉。息肉切除术后,着床率和临床妊娠率均显著提高。
既往 ART 失败患者的宫腔镜检查异常发现明显更高,宫腔镜检查可作为既往 RIF 妇女随后 IVF 过程中妊娠的阳性预后因素。