Hysteroscopic Endometrial Biopsy after Intracytoplasmic Sperm Injection Failure for women with Unexplained Infertility

Abstract

Background: Hysteroscopy is one of the most significantexaminations in females with recurrent implantation failure (RIF). It permits dependable visual evaluation of the cervical canal and uterine space and it taken into consideration as a gold standard for diagnosing intra-uterine pathology and has slight intra-operative and postoperative morbidities. Objectives: This work aimed to clarify the roles of Hysteroscopy and endometrial biopsy in evaluation of endometrium after ICSI failure in females with un-explained Infertility. Patients and methods: This was a prospective cohort investigation carried out at outpatient infertility clinic of the Assisted Reproductive Unit, Obstetrics and Gynecology department, Qena University Hospital. Women attend to Assisted Reproductive unit planned for intracytoplasmic sperm injection (ICSI). Results: Based on histology as a reference standard, hysteroscopy identified the chronic endometritis pathology in 26 patients (true positives) that also found by histology. Our study revealed that Hysteroscopy had overall sensitivity, specificity, and diagnostic accuracy of 49.06%, 53.19% and 51% respectively in detecting the chronic endometritis in our patients with positive predictive value (PPV) was 54.17% while the negative predictive value (NPV) was 48.08%. Conclusion: Hysteroscopy is of a great value in the assessment and diagnosis of the endometrial pathology in patients with unexplained RIF. There is no consensus on the everyday use of hysteroscopy before ICSI; hence, the importance of hysteroscopy as a routine in the managing of non-fertile females still remains a subject of investigation.