Volume 6, Issue 2 (7-2008)                   IJRM 2008, 6(2): 19-0 | Back to browse issues page

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Arefi S, Soltanghoraee H, Zarnani A H, Sadeghpour Tabaei A, Ghaffari Novin M, Zeraati H et al . Repeated IVF/ICSI-ETs failures and impact of hysteroscopy. IJRM 2008; 6 (2) :19-0
URL: http://ijrm.ir/article-1-96-en.html
Repeated IVF/ICSI-ETs failures and impact of hysteroscopy
Soheila Arefi1 , Haleh Soltanghoraee * 2, Amir Hassan Zarnani1 , Ali Sadeghpour Tabaei3 , Marefat Ghaffari Novin4 , Hojat Zeraati5 , Pegah Ebadi6
1- Reproductive Immunology Department, Reproductive Biotechnology Research Center, Avicenna Research Institute, Avesina Infertility Center, Tehran, Iran
2- Genetic Departement, Reproductive Biotechnology Research Center, Avicenna Research Institute, Avesina Infertility Center, Tehran, Iran
3- Iran University, Shahid Rajaei Hospital, Tehran, Iran
4- Cellular and Molecular Biology Research Center, Shaheed Beheshti University (M.C.), Tehran, Iran
5- Tehran University of Medical Sciences, School of Public Health, Department of Epidemiology and Biostatistics
6- Reproductive Endocrinology and Embryology Departement, Reproductive Biotechnology Research Center, Avicenna Research Institute, Avesina Infertility Center, Tehran, Iran
Abstract:   (3199 Views)
Background: Despite numerous developments in the field of assisted reproduction, the implantation rate remains low. Among the various reasons of implantation failure, endometrial regularity has an important role. Hysteroscopy is an accurate method for evaluating the endometrial characteristics, with the ability to treat uterine pathology.
Objective: The aim of the present study was to evaluate the findings on hysteroscopy and thereafter the result of subsequent IVF/ICSI in infertile women with the history of frequent unexplained and unsuccessful IVF/ICSI attempts.
Materials and Methods: In this observational study, the hysteroscopy findings and the outcomes of subsequent IVF/ICSI were evaluated in 89 infertile women admitted in Avicenna Infertility Clinic, with previous repeated (more than two) failed IVF/ICSI-ETs, including the patients with normal Hysterosalpinography (HSG) and excluding severe male factor infertility and also thrombophilia, genetic and immunologic problems. The data were analyzed with SPSS software and Fisher exact, chi-square, and MC-Nemar tests.
Results: In 53 (59.5%) cases, hysteroscopy revealed abnormal intrauterine findings including adhesions 7 (13.7%), single polyp 11 (20.7%), endometrial polyposis 10 (18.8%), endometrial hyperplasia 10 (18.8%), uterine cavity hypoplasia 4 (7.8%) and myoma 5 (9.8%). These abnormalities were significantly higher in women with more than 8 years of infertility (chi-square=4.7, p-value=0.03). After hysteroscopy and subsequent IVF/ICSI-ET attempt using standard long protocol, pregnancy rate were significantly higher compared with the previous repeated IVF/ICSI attempts (35.8% versus 0%). Conclusion: According to this study, we strongly suggest evaluation of endometrial integrity by hysteroscopy in patients with repeated IVF/ICSI-ETs failure, before entering any other fertilization procedures.
Keywords: Hysteroscopy, Repeated IVF/ICSI -ET failure
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Type of Study: Original Article |
References
1. Margalioth EJ, Ben -Chetrit A, Gal M, Eldar Geva T. Investigation and treatment of repeated implantation failure following IVF-ET. Hum Reprod 2006; 21: 3036-3043. [DOI:10.1093/humrep/del305]
2. Putowski L, Darmochwal-Kolarz D, Rolinski J,Oleszczuk J, Jakowicki J. The immunological profile in infertile women after repeated IVF failures (preliminary study). Eur J Obstet Gynecol Reprod Biol 2004; 112: 192-196. [DOI:10.1016/j.ejogrb.2003.06.012]
3. Azem F, Many A, Ben Ami I, Yovel I, Amit A, Lessing JB, et al. Increased rate of thrombophilia in women with repeated IVF failure. Hum Reprod 2004; 19: 368-370. [DOI:10.1093/humrep/deh069]
4. Laird SM, Tuckerman EM, Li TC. Cytokine expression in the endometrium of women with implantation failure and recurrent abortion. Reprod Biomed Online 2006; 13: 13-23. [DOI:10.1016/S1472-6483(10)62011-1]
5. Raziel A, Friedler S, Schachter M, Kasterstein E, Strassburger D, Ron-El R. Increased frequency of female partner chromosomal abnormalities in patients with high order implantation failure after in vitro fertilization. Fertil Steril 2002; 78: 515-519. [DOI:10.1016/S0015-0282(02)03298-3]
6. Stern C, Pertile M, Norris H, Hale L, Baker HW. Chromosomal translocations in couples with in vitro fertilization implantation failure. Hum Reprod 1999; 14: 2097-2101 [DOI:10.1093/humrep/14.8.2097]
7. Golan A, Ron-El R, Herman A, Soffer Y, Bukovsky I, Caspi E. Diagnostic hysteroscopy: its value in an in-vitro fertilization/embryo transfer unit. Hum Reprod 1992; 7:1433-1434. [DOI:10.1093/oxfordjournals.humrep.a137589]
8. Shalev J, Meizner I, Bar-Hava I, Dicker D, Mashiach R, Ben-Rafael Z. Predictive value of transvaginal sonography performed before routine diagnostic hysteroscopy for evaluation of infertility. Fertil Steril 2000; 73: 412-417. [DOI:10.1016/S0015-0282(99)00533-6]
9. Hauge K, Flo K, Riedhart M, Granberg S. Can ultrasound -based investigations replace laparascopy and hysteroscopy in infertility? Eur J Obstet Gynecol Reprod Biol 2000; 92:167-170. [DOI:10.1016/S0301-2115(00)00442-5]
10. de Kroon CD, de bock GH, Dieben SW, Jansen FW. Saline hysterosonography in abnormal uterine bleeding: a systematic review and meta-analysis. BJOG 2003; 110: 938-947. [DOI:10.1111/j.1471-0528.2003.02472.x]
11. Kelekci S, Kaya E, Alan M, Alan Y, Bilge U, Mollamahmutoglu L. Comparison of transvaginal sonography, saline infusion sonography, and office hysteroscopyin Reproductive- aged women with or without abnormal uterine bleeding. Fertil Steril 2005; 84: 682-686. [DOI:10.1016/j.fertnstert.2005.03.036]
12. Rogerson L, Bates J, Weston M, Duffy S. A comparison of outpatients hysteroscopy with saline infusion hysterosonography. BJOG 2002; 109:800-804. [DOI:10.1111/j.1471-0528.2002.01478.x]
13. Schiano A, Jourdain O, Papaxanthos A, Hocke C, Horovitz J, Dallay D. The value of hysteroscopy after repeated implantation failures with in vitro fertilization. Contracept Fertil Sex 1999; 27: 129-132.
14. Noyes N. Hysteroscopic cervical canal shaving: A new therapy for cervical stenosis before embryo transfer in patients undergoing in vitro fertilization. Fertil Steril 1999; 71: 965-966. [DOI:10.1016/S0015-0282(99)00097-7]
15. Dicker D, Ashkenazi J, Feldberg D, Farhi J, Shalev J, Ben-Rafael Z. The value of repeat hysteroscopic evaluation in patients with in vitro fertilization transfer cycles. Fertil Steril 1992; 58: 833-835. [DOI:10.1016/S0015-0282(16)55338-2]
16. Makris N, Xygakis A, Michalas S, Dachlythras M, Prevedourakis C. Day clinic diagnostic hysteroscopy in a state hospital. Clin Exp Obstet Gynecol 1999; 26:91-92.
17. Alborzi S, Dehbashi S, Khodaee R. Sonohysterosal-pingographic screening for infertile patients. Int J Gynaecol Obstet 2003; 82(1): 57-62. [DOI:10.1016/S0020-7292(02)00417-4]
18. Alborzi S, Parsanezhad ME, Mahmoodian N, Alborzi S, Alborzi M . Sonohysterography versus transvaginal Sonography for screening of patients with abnormal uterine bleeding. Int J Gynaecol Obstet 2007; 96: 20-23. [DOI:10.1016/j.ijgo.2006.09.004]
19. diagnosis and treatment of infertility. Rev Med Chir Soc Med Nat Iasi 2005; 109: 537-541.
20. Mihaila C, Anton E. Significance of hysteroscopy in the Ragni G, Diaferia D, Vegetti W, Colombo M, Arnoldi M, Crosignani PG. Effectiveness of sonohysteroscopy in infertile patient workshop: a comparison with transvaginal ultrasonography and hysteroscopy. Gynecol Obstet Invest 2005; 59:184-188. [DOI:10.1159/000084294]
21. Faghali J, Bakar J, Mayenga JM, Ségard L, Hamou J, Driguez P, et al. Systematic hysteroscopy prior to in vitro fertilization. Gynecol Obstet Fertil 2003; 31: 127-131. [DOI:10.1016/S1297-9589(03)00007-9]
22. La Sala GB, Montanari R, Dessanti L , Cigarini C, Sartori F. The role of diagnostic hysteroscopy and endometrial biopsy in assisted reproductive endocrinologies. Fertil Steril 1998; 70:378-380. [DOI:10.1016/S0015-0282(98)00147-2]
23. Oliveria FG, Abdelmassih VG, Diamond MP, Dozortsev D, Nagy ZP, Abdelmassih R. Uterine cavity findings and hysteroscopic interventions in patients undergoing in vitro fertilization -embryo transfer who repeatedly cannot conceive. Fertil Steril 2003; 80: 1371-1375. [DOI:10.1016/j.fertnstert.2003.05.003]
24. Kdous M, Hachicha R, Zhiou F, Ferchiou M, Chaker A, Meriah S. Fertility after hysteroscopic treatment of intra-uterine adhesions. Gynecol Obstet Fertil 2003; 31: 422-428. [DOI:10.1016/S1297-9589(03)00101-2]
25. Pabuccu R, Ceyhan ST , Onalan G, Goktolga U, Ercan CM, Selam B. Successful treatment of cervical stenosis with hysteroscopic canalization before embryo transfer in patients undergoing IVF: A case series. J Minimum Invasive Gynecol 2005; 12: 436-438. [DOI:10.1016/j.jmig.2005.06.003]
26. Woolcott R, Petchpud A. The efficacy of hysteroscopy: a comparison of women presenting with infertility versus other gynaecological symptoms. Aust N Z J Obstet Gynaecol 1996; 36: 226-227.
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