title: Impact of office hysteroscopy in repeated implantation failure: Experience of a single center.
abstract: OBJECTIVE
  Repeated implantation failure (RIF) is a clinical entity affecting many couples undergoing assisted reproductive technology (ART). Various intrauterine pathologies contribute to RIF. Nevertheless, vaginal sonography and hysterosalpingography, which are the common diagnostic tools for the initial follow-up, have limited sensitivities. In this context, we aimed to evaluate the impact of office hysteroscopy (oHS) on live birth rates (LBRs) when performed prior to subsequent ART cycles in women with a history of RIF.
  
  
  METHODS
  The database of an assisted reproduction center was retrospectively reviewed to detect eligible cases. A total of 363 women out of 2875 admissions were consecutively included in the analysis, of which 119 formed the oHS group and 244 formed the non-oHS group prior to a new ART cycle. Women in the oHS arm were examined during their early follicular phase via a vaginoscopic approach 1-6 months before the beginning of a new cycle. The standardin-vitrofertilization-intracytoplasmic sperm injection (IVF/ICSI) cycle was applied to all the women.
  
  
  RESULTS
  In the oHS group (n=119), 61 patients had intrauterine abnormalities, with an overall abnormality rate of 51.2%. Implantation, pregnancy, and LBRs of the groups were statistically similar. LBRs of the women with abnormal oHS findings (15/61, 24.5%), with normal oHS findings (14/58, 24.1%), and without oHS (39/244, 16%) were statistically similar (p=0.41).
  
  
  CONCLUSIONS
  Unrecognized intrauterine pathologies can be easily detected and concurrently treated during oHS with high success rate. However, a beneficial impact depends on the extent of the pathology and thus, routine application to enhance reproductive outcomes is still not warranted.
authors.affiliation: Department of Obstetrics and Gynecology, Ufuk University School of Medicine, Ankara, Turkey.
authors.forename: Emre Göksan
authors.initials: EG
authors.lastname: Pabuçcu
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health and Research Hospital, Ankara, Turkey.
authors.forename: İbrahim
authors.initials: İ
authors.lastname: Yalçın
authors.affiliation: Department of Obstetrics and Gynecology, Yücelen Muğla Hospital, Muğla, Turkey.
authors.forename: Taylan
authors.initials: T
authors.lastname: Bodur
authors.affiliation: Department of Obstetrics and Gynecology, Ufuk University School of Medicine, Ankara, Turkey.
authors.forename: Gamze Sinem
authors.initials: GS
authors.lastname: Çağlar
authors.affiliation: Department of Obstetrics and Gynecology, Ufuk University School of Medicine, Ankara, Turkey; Centrum Clinic Women's Health and ART Centre, Ankara, Turkey.
authors.forename: Recai
authors.initials: R
authors.lastname: Pabuçcu
keywords: Endometrium; in-vitro fertilization; office hysteroscopy; pregnancy