title: Uterine cavity findings and hysteroscopic interventions in patients undergoing in vitro fertilization-embryo transfer who repeatedly cannot conceive.
abstract: OBJECTIVE
  To assess hysteroscopic findings in patients undergoing IVF-ET who repeatedly failed to conceive despite transfer of good-quality embryos.
  
  
  METHODS
  Prospective, observational study.
  
  
  METHODS
  Clinical research unit for reproductive medicine in a private clinic.
  
  
  METHODS
  Fifty-five patients with a normal uterine cavity on hysterosalpingography before the initial IVF-ET cycle and two previous failed IVF-ET attempts despite transfer of a minimum of two good-quality embryos on each occasion.
  
  
  METHODS
  Standard transvaginal ultrasonography and diagnostic and therapeutic hysteroscopy.
  
  
  METHODS
  Endometrial findings on transvaginal ultrasonography and hysteroscopy and outcome of the cycles after surgical hysteroscopy and antibiotic therapy.
  
  
  RESULTS
  Twenty-five (45%) patients had abnormal endometrial findings and underwent treatment to correct the lesions. All patients underwent a third IVF-ET cycle. Pregnancy (50% vs. 20%) and implantation (19% vs. 5.5%) rates were significantly higher in patients who were treated for uterine abnormalities than in patients who had normal uterine cavities on hysteroscopy.
  
  
  CONCLUSIONS
  The incidence of pathologic findings on hysteroscopy is high in patients with repeated failures of IVF-ET. Evaluation of endometrial integrity by hysteroscopy is highly valuable and should be applied to all such cases.
authors.affiliation: Clínica e Centro de Pesquisa em Reprodução Humana Roger Abdelmassih, São Paulo, SP, Brazil. flaviogo2@uol.com.br
authors.forename: Flávio G
authors.initials: FG
authors.lastname: Oliveira
authors.forename: Vicente G
authors.initials: VG
authors.lastname: Abdelmassih
authors.forename: Michael P
authors.initials: MP
authors.lastname: Diamond
authors.forename: Dimitri
authors.initials: D
authors.lastname: Dozortsev
authors.forename: Zsolt P
authors.initials: ZP
authors.lastname: Nagy
authors.forename: Roger
authors.initials: R
authors.lastname: Abdelmassih
mesh_terms: D004624:Embryo Transfer; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging; D004715:Endometriosis / Q000000981:diagnostic imaging; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007047:Hysterosalpingography; D007247:Infertility, Female / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D016896:Treatment Outcome; D014599:Uterus / Q000502:physiology* / Q000503:physiopathology