Effect of treatment of intrauterine pathologies with office hysteroscopy in patients with recurrent IVF failure

Demi̇rol, Aygül; Gürgan, Timur

doi:10.1016/s1472-6483(10)61108-x

Cited by 216 publications

(159 citation statements)

References 28 publications

Supporting

Mentioning

138

Contrasting

Unclassified

Order By: Relevance

“…It has been shown that the fertility-enhancing effect of oHS could also be independent from the correction of intrauterine abnormalities. Hysteroscopy has been proposed to improve ART outcomes through an endometrial injury process leading to embryo implantation (23,24). The outcomes of the women in the oHS arm without any pathologic findings being generally more favorable compared to those without oHS in our data is speculating this impact.…”

Section: Discussionmentioning

confidence: 54%

Impact of office hysteroscopy in repeated implantation failure: Experience of a single center

Pabuçcu¹,

Yalçın²,

Bodur³

et al. 2016

J Turkish German Gynecol Assoc

View full text Add to dashboard Cite

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. Material and 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 standard in-vitro fertilization-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). Conclusion: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. (J Turk Ger Gynecol Assoc 2016; 17: 197-200) Keywords: Endometrium, in-vitro AbstractSubjects who underwent the procedure formed the oHS group, whereas the remaining subjects formed the non-oHS group. All included patients were between 18 and 40 years of age and had follicle-stimulating hormone (FSH) levels of <15 IU/mL. The exclusion critertia were 1) poor ovarian response according to the Bologna criteria (8) or women with premature ovarian failure; 2) male subjects with severe oligozoospermia, oligoasthenozoospermia, or azoospermia; 3) preimplantation genetic screening and cryopreserved/thawed embryo transfer cycles; 4) women with confirmed endometriosis; 5) women with hypothalamic amenorrhea; and 6) women who underwent oHS more than 6 months prior to a new cycle.Office hysteroscopy procedure All patients were examined during their early follicular phase, 1-6 months before the start of a new ART cycle, via the vaginoscopic approach as previously described (9). No routine preoperative analgesia, antibiotics, sedation, or cervical preparation was used. Briefly, a rigid hysteroscope (continuous flow; 30° forward oblique view) with an outer diameter of 4 mm using 0.9% normal saline was used. Following adequate distension of the uterine cavity, systematic inspection was performed. Standard g...

show abstract

Section: Discussionmentioning

confidence: 54%

Impact of office hysteroscopy in repeated implantation failure: Experience of a single center

Pabuçcu¹,

Yalçın²,

Bodur³

et al. 2016

J Turkish German Gynecol Assoc

View full text Add to dashboard Cite

show abstract

“…Daha önce yapılan çalışma-larda bu oran %11-45 arasında bildirilmiştir. 3,4 Sonuçları hasta populasyonunun yaşı, hormonal durumları, etnik faktörler ve infertilite tipi de etkileyebilir. Çalışmaların çoğunda IVF öncesi ofis histeroskopi ile saptanmış olan anormal bulguların oranı verilmiş olmasına rağmen, bu patolojik bulguların tedavi edilmesi sonucunda fayda gören ve gebe kalan hastaların oranlarından bahsedilmemektedir.…”

Section: Discussionunclassified

“…2 Gözardı edilmemesi gereken, bu uterin kaynaklı patolojilerin sıklığının yapılan çalışma-larda %11-45 oranında bulunmasıdır. 3,4 Bu patolojilerin ekarte edilebilmesi için kavitenin çok iyi bir şekilde değerlendirilmesi gerekmektedir.…”

unclassified

The Usefullness of Office Hysteroscopy in Evaluation of Infertil Women Prior to In Vitro Fertilization Cycles

Yılmaz¹,

İnal²,

Hancerliogullari³

et al. 2016

Turkiye Klinikleri J Gynecol Obst

View full text Add to dashboard Cite

13İn Vitro Fertilizasyon Öncesi İnfertilitenin Değerlendirilmesinde Ofis Histeroskopinin Kullanılabilirliği Ö ÖZ ZE ET T A Am ma aç ç: : Ofis histeroskopi ile uterin kavite ve servikal kanal değerlendirilmektedir. Bu çalışma-nın amacı in vitro fertilizasyon (IVF) tedavisi öncesi yapılan ofis histeroskopi ile saptanan patolojik bulguları ve maliyet analizini değerlendirmektir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Bu çalışmada, Dr. Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesine Temmuz 2013-Aralık 2014 tarihleri arasında infertilite nedeni ile başvuran ve IVF kararı verilen ve ofis histeroskopi uygulanan 301 hasta retrospektif olarak değerlendirildi. Tüm ofis histeroskopi işlemleri tek bir hekim tarafından gerçekleştirildi. B Bu ul lg gu ul la ar r: : Hastalarımızın yaş ortalaması 30,69+5,31 yıl idi. İntrauterin patoloji 38 (%12,6) hastada gözlemlenirken, 263 (%87,4) hastada normal histeroskopik bulgular izlendi. Saptanan patolojilerin dağılımları şöyle idi: Endometriyal polip 13 (%4,3), uterin subseptus 11 (%3,7), servikal stenoz 4 (%1,3), endoservikal polip 3 (%1), uterin septum 3 (%1), unikornuat uterus 2 (%0,7) ve Asherman sendromu 2 (%0,7). Bu bulgular eşliğinde bir spesifik patolojiyi saptayabilmek için sekiz infertil hastaya histeroskopi yapılması gerekmekte idi. S So on nu uç ç: : IVF öncesi uterin kavite ve servikal kanalın rutin olarak değerlendirilmesinde kullanılan ofis histeroskopi, aynı zamanda uterin kavitede meydana getirdiği lokal hasar ile de endometriyal implantasyonu artırarak klinik gebelik şansını artırmakta ve deneme transferi fırsatı da sunmaktadır. Ancak, gelişmekte olan ülkelerde ofis histeroskopinin ekonomik açıdan oldukça maliyetli olması göz önünde bulundurulduğunda transvajinal ultrasonografi ya da salin-infüzyon-sonohisterografi ile uterin kavitenin değerlendirilmesi önerilebilir.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : İnfertilite, kadın; histeroskopi; in vitro fertilizasyon; sperm enjeksiyonu, intrasitoplazmik A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Office hysteroscopy allows assesment of uterin cavity and cervical canal. The objective of this study is to determine the cost-effectivity and pathology finding of office hysteroscopy before in vitro fertilization (IVF) treatment. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : The cases of 301 patients, who had referred to Dr. Zekai Tahir Burak Women's Health Research and Training Hospital between July 2013 and December 2014 because of infertility and for whom IVF had been planned, were retrospectively analyzed. All the office hysteroscopy procedures were performed by a single physician. R Re es su ul lt ts s: : The mean age of our patients was 30.69+5.31. Intrauterine pathology was observed in 38 (12.6%) patients and 263 (87.4%) patients displayed normal hysteroscopic finding. The distribution of the pathologies were as follows: endometrial polyp 13 (4.3%), uterine subseptus 11 (3.7%), cervical stenosis 4 (1.3%), endocervical polyp 3 (1%), uterine septum 3 (...

show abstract

“…In a prospective randomized study conducted with 415 IVF patients, it was concluded that polypectomy was effective and increased pregnancy rates compared to the control group (8). In another study of 215 infertile patients where polypectomy was performed before intrauterine insemination, it was concluded that polypectomy increased the pregnancy rate 2.1 times (9).…”

Section: Discussionmentioning

confidence: 99%

The Role of Saline Infusion Sonohysterography in the Evalution of the Uterus of Infertile Patients

Aydin¹,

Kumbasar²,

Salman³

et al. 2015

JAREM

View full text Add to dashboard Cite

INTRODUCTIONEvaluating the uterus is an inseparable part of routine infertility research. During the evaluation of the uterus through transvaginal ultrasound (TvUSG), endometrial imaging using contrast media has been used in clinical practice. This method is less invasive and cheaper than hysterosalpingography (HSG) and hysteroscopy (H/S). Saline infusion sonohysterography (SIS) comprises transcervical infusion of a sterile saline solution to the endometrial lumen during TvUSG. Saline expands the uterine cavity and forms a perfect contrast in defining the echogenic endometrium because it is anechoic. This technique was first described 27 years ago (1). Its high sensitivity and efficiency in detecting endometrial polyps, submucosal fibroids (myoma), synechiae, and uterine abnormalities have been proved in some studies (2, 3). In recent meta-analysis, SIS was compared with hysterectomy, H/S, and histological sampling, which are the gold standard diagnostic methods. It was found that SIS is easily applicable and has high accuracy in diagnosing abnormal uterine bleeding (4). In addition, SIS is less invasive and less expensive than HSG and H/S. In this study, we evaluated the uterus through SIS as part of routine infertility research. We planned a prospective study for this purpose. We investigated whether SIS could be used as a part of infertility research. METHODSSaline infusion sonohysterography was performed in 102 infertile women in our center for infertility research. Patients were informed about the procedure, and their written informed consent was obtained. After SIS, they were referred to the relevant departments for additional diagnostic and therapeutic procedures (laparoscopy or H/S) when required. Data were prospectively collected. The results that we obtained were compared with a large patient cohort where only HSG and TvUSG were used for uterine evaluation.Women with regular menstrual cycles were examined in the follicular phase of their cycles. First, two-dimensional TvUSG was routinely performed. Then, SIS was performed. A 5-MHz frequency vaginal probe (Toshiba justvision 400, Tokyo, Japan) was used in both procedures. The cervix was reached with a standard bivalve disposable vaginal speculum. The cervix was wiped with povidone-iodine. Then, an 8-F balloon-tipped catheter was driven up to the back of the os through the cervical canal and placed. The balloon was inflated with 1 cc of saline. Then, the catheter was brought into the proper position by gentle pulling. After removing the speculum, the vaginal probe was placed again. The endometrial lumen was expanded by slowly injecting 20-50 mL of saline along with TvUSG. Images were taken in the midsagittal section. At the end of the process, the balloon was emptied Methods: One hundred and two infertile patients who were referred to Süleymaniye Obstetrics and Gynecology Hospital because of infertility underwent saline infusion sonohysterography (SIS) at our clinic. The cases were informed about the procedure, and consent forms were obtained. Data was c...

show abstract

Effect of treatment of intrauterine pathologies with office hysteroscopy in patients with recurrent IVF failure

Cited by 216 publications

References 28 publications

Impact of office hysteroscopy in repeated implantation failure: Experience of a single center

Impact of office hysteroscopy in repeated implantation failure: Experience of a single center

The Usefullness of Office Hysteroscopy in Evaluation of Infertil Women Prior to In Vitro Fertilization Cycles

The Role of Saline Infusion Sonohysterography in the Evalution of the Uterus of Infertile Patients

Contact Info

Product

Resources

About