title: Successful treatment of cervical stenosis with hysteroscopic canalization before embryo transfer in patients undergoing IVF: a case series.
abstract: The course of the transfer catheter through the cervical canal is one of the most important issues for a successful embryo transfer (ET) during in vitro fertilization (IVF) cycles. Technically difficult ETs due to cervical stenosis are associated with reduced chance of pregnancy after assisted reproductive procedures. In the current case series, we report on three patients with cervical stenosis who underwent IVF-ET cycles. These three patients, in whom ET was classified as "difficult," failed to conceive with previous ET attempts. An intervention to create a cervical tract was performed with operative hysteroscopy under general anesthesia before transcervical ET. After the hysteroscopic shaving procedure, we observed quite an improvement in access to the endometrial cavity during ET procedure. These patients had significantly easier ET procedures compared with previous attempts and achieved clinical pregnancies. Hysteroscopic revision of the cervical canal results in easier ET and improves pregnancy rates in patients with cervical stenosis and histories of difficult ET.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Gulhane Military Medical Academy and Medical School, Ankara, Turkey.
authors.forename: Recai
authors.initials: R
authors.lastname: Pabuccu
authors.forename: Seyit Temel
authors.initials: ST
authors.lastname: Ceyhan
authors.forename: Gogsen
authors.initials: G
authors.lastname: Onalan
authors.forename: Umit
authors.initials: U
authors.lastname: Goktolga
authors.forename: Cihangir Mutlu
authors.initials: CM
authors.lastname: Ercan
authors.forename: Belgin
authors.initials: B
authors.lastname: Selam
mesh_terms: D000328:Adult; D002404:Catheterization / Q000295:instrumentation* / Q000379:methods; D002584:Cervix Uteri / Q000473:pathology; D003251:Constriction, Pathologic / Q000628:therapy; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D015907:Hysteroscopy; D007247:Infertility, Female / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D002577:Uterine Cervical Diseases / Q000628:therapy*