Hysteroscopy in women with implantation failures after in vitro fertilization: findings and effect on subsequent pregnancy rates.
OBJECTIVE
To evaluate hysteroscopic findings and estimate the effect of hysteroscopy on achieving a pregnancy in women with a history of 2 implantation failures after in vitro fertilization (IVF).


METHODS
Prospective observational and matched case control study.


METHODS
II-2.


METHODS
Private assisted reproduction units.


METHODS
A total of 1475 patients with a history of 2 consecutive implantation failures after IVF who had a hysteroscopy were studied; there were 414 matched pairs of women with a similar history who either had or did not have a hysteroscopy.


METHODS
Hysteroscopy (diagnostic or operative), IVF/intracytoplasmic sperm injection cycle.


RESULTS
Hysteroscopic findings, clinical pregnancy rate (CPR), and ongoing pregnancy rate (OPR) were measured. In all, 36.6% of the study population had abnormal hysteroscopic findings and 22.2% had unsuspected findings; women with abnormal hysteroscopic findings showed significantly increased CPR and increased OPR in a new IVF cycle compared with those with a normal hysteroscopy result. Women who had a hysteroscopy showed significantly increased CPR and OPR compared with matched control subjects who did not have the procedure. Hysteroscopy and appropriate therapy significantly increased the chances of achieving a subsequent clinical and ongoing pregnancy.


CONCLUSIONS
Women with 2 implantation failures after IVF had a remarkably high possibility for unsuspected abnormalities seen at hysteroscopy. Hysteroscopy could serve as a positive prognostic factor for achieving a subsequent pregnancy.
Makrakis
Evangelos
E
Embryo ART Unit, Athens, Greece. emakrakis@hotmail.com
Hassiakos
Dimitrios
D
Stathis
Dimitrios
D
Vaxevanoglou
Terpsi
T
Orfanoudaki
Eleni
E
Pantos
Konstantinos
K
D000328:Adult; D016022:Case-Control Studies; D004717:Endometrium / Q000473:pathology / Q000601:surgery; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D015907:Hysteroscopy; D007247:Infertility, Female / Q000209:etiology*; D011247:Pregnancy; D018873:Pregnancy Rate; D017211:Treatment Failure; D014591:Uterine Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery