Hysteroscopic evaluation of endocervical and endometrial lesions observed after different procedures of embryo transfer: a prospective comparative study.
OBJECTIVE
Endocervical and endometrial damage observed after different procedures of embryo transfer (ET) were investigated using diagnostic hysteroscopy.


METHODS
Prospective, descriptive and comparative study, in an Infertility centre, University Hospital. Hundred consecutive infertile patients with a normal uterine cavity, included in an IVF program, were enrolled between May 1st, 2006 and April 30th, 2007. All the patients had a diagnostic hysteroscopy immediately after trial ET using soft ET catheters: (i) IVF Sydney Set (Cook, Limerick, Ireland) (n=27), (ii) Elliocath (Ellios, Paris, France) (n=34), (iii) Frydman classic 4.5 (CCD, Paris, France) (n=19), and rigid ET catheters: Memory Frydman 4.5 (CCD, Paris, France) (n=20). All the procedures were recorded and blindly reviewed. Data were analyzed using a Kruskal-Wallis test for age and severity of endometrial lesions, or Fisher's exact test for binary criteria.


RESULTS
Endocervical lesions were more frequently encountered in the soft (63%) and rigid (85%) Frydman's catheter groups compared to other groups (Elliocath: 29%, IVF Sydney Set: 26%; p<0.0001). Presence of blood on the catheter, and endometrial lesions were significantly less frequent in soft catheter groups compared to the rigid catheter group (p<0.0001). Severe endometrial lesions were less frequently observed when soft catheters were used (85%, 53%, 32%, 11% for Memory Frydman, Frydman classic, Elliocath and IVF Sydney Set, respectively; p<0.0001). The presence of blood on the catheter signed severe endometrial lesions.


CONCLUSIONS
All ET catheters can lead to endocervical and endometrial damage. Severe endometrial lesions were less frequent when soft catheters were used.
Poncelet
Christophe
C
Department of Obstetrics and Gynecology, CHU Jean Verdier, AP-HP, Bondy, France. christophe.poncelet@jvr.aphp.fr
Sifer
Christophe
C
Hequet
Delphine
D
Porcher
Raphael
R
Wolf
Jean-Philippe
JP
Uzan
Michèle
M
Ducarme
Guillaume
G
D000328:Adult; D002404:Catheterization; D002584:Cervix Uteri / Q000473:pathology*; D004624:Embryo Transfer / Q000295:instrumentation / Q000379:methods*; D004717:Endometrium / Q000473:pathology*; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D011446:Prospective Studies