ارزش هيستروسكوپي در بيماران نابارور با شكست مكرر لانه گزيني در سيكلهاي ICSI / IVF

The value of diagnostic hysteroscopy in patients with repeated IVF failures

Background: The aim of the present study was to assess hysteroscopy findings in infertile pa tients undergoing IVF-ICSI-ET (In Vitro Fertilization by Intra Cytoplasmic Single Sperm Injection & Embryo Transfer) who repeatedly failed to conceive, despite transfer of good-quality embryos, after exclusion of other causes of implantation failures, with special concerns to age and duration of infertility. Methods: This observational study included 89 patients with three previous IYF-ICSI-ET failures. After exclusion of thrombophilia, genetic and immunologic problems, uterine malformations and severe male factor infertility, the patients underwent diagnostic and therapeutic hysteroscopy under general anesthesia. The data were analyzed by SPSS software using Fisher¢s exact, chi-square, and Mc-Nemarʹ s tests. Results: From the total number of 89 patients, 53 (59.5%) were found to have intrauterine abnormalities on hysteroscopy, such as adhesions in seven ( 13.7%), single polyps in I I (20.7%), endometrial polyposis in 10 (18.8%), endometrial hyperplasias in 10 (J8.8%), uterine cavity hypoplasias in four (7.8%) and myomas in five (9.8%) patients. Conclusions: The incidence of pathologic findings on hysteroscopy was high, especially after excluding other related causes, in patients with repeated failures of IVF-ICSI-ET. Routine hysteroscopy before starting the second IVFIICSI program should be seriously considered in patients with previous repeated IVF failures. Evaluation of endometria l integrity by hysteroscopy is highIy valuable and should bc applied to all such cases. The incidences of the mentioned pathological findings were higher in patients with an infertility history of more than 8 years.