Effect of office hysteroscopy on in-vitro fertilization in a fertility centre in Abuja, Nigeria: A prospective study

Abstract

Background: Fifteen percent of married couples worldwide experience infertility despite unprotected intercourse and approximately 50% of infertile women has uterine pathologies. The success of in vitro fertilization can be assessed using various measures including pregnancy rate, implantation rate and the most acceptable, live birth rate. Various modalities have been employed to investigate endometrial pathologies responsible for infertility.
 Objectives: To determine and compare the incidence, and pathology in infertile women seen on hysteroscopy and TVS, and the effect on IVF success
 Methods: This study had 41 participants, 24 had previous Assisted Reproductive Therapy while 17 had not undergone the process. The 41 participants included those that had both TVS and office hysteroscopy. Abnormal findings were recorded and management carried out based on the abnormality detected.
 Result: Forty-one infertile women aged 26 to 45 years were included in the study. About fifty-eight percent had history of IVF attempts, while 41.46% had no history of IVF. TVS and hysteroscopic examinations were performed on all the patients. TVS findings indicated 26.83% normal findings and 73.17% abnormal pelvic findings. Hysteroscopic findings showed 90.25% patients had abnormal uterine findings
 Conclusion: This study shows that Hysteroscopy is more sensitive and useful in the diagnosis and treatment of infertility than TVS. Diagnostic measures for hysteroscopic detection of uterine lesions revealed a sensitivity of 78.95% (95% CI 62.68- 90.45), 100% specificity and positive predictive value, with a Negative predictive value of 33.33% (95% CI 21.27 – 48.07) and diagnostic accuracy of 80.95% (95% CI 65.88 – 91.40). These are in keeping with other studies.