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). DESIGN: Prospective observational and matched case control study. DESIGN CLASSIFICATION: II-2. SETTING: Private assisted reproduction units. PATIENTS: 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. INTERVENTIONS: Hysteroscopy (diagnostic or operative), IVF/intracytoplasmic sperm injection cycle. MEASUREMENTS AND MAIN 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. CONCLUSION: 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.
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). DESIGN: Prospective observational and matched case control study. DESIGN CLASSIFICATION: II-2. SETTING: Private assisted reproduction units. PATIENTS: 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. INTERVENTIONS: Hysteroscopy (diagnostic or operative), IVF/intracytoplasmic sperm injection cycle. MEASUREMENTS AND MAIN 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. CONCLUSION: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.
Authors: Janine G Smit; Jenneke C Kasius; Marinus J C Eijkemans; Carolien A M Koks; Ron Van Golde; Jurjen G E Oosterhuis; Annemiek W Nap; Gabrielle J Scheffer; Petra A P Manger; Annemiek Hoek; Mesrure Kaplan; Dick B C Schoot; Arne M van Heusden; Walter K H Kuchenbecker; Denise A M Perquin; Kathrin Fleischer; Eugenie M Kaaijk; Alexander Sluijmer; Jaap Friederich; Joop S E Laven; Marcel van Hooff; Leonie A Louwe; Janet Kwee; Jantien J Boomgaard; Corry H de Koning; Ineke C A H Janssen; Femke Mol; Ben W J Mol; Helen L Torrance; Frank J M Broekmans Journal: BMC Womens Health Date: 2012-08-08 Impact factor: 2.809