P-61: Effects of endometrial evaluation with office hysteroscopy in IVF-ET patients with repeated failures

Abstract

One of the most consistent factors for the success of in vitro fertilization and embryo transfer (IVF-ET) is known to be the quality of the embryos. However, the significance of embryo quality in determining pregnancy rates should not be considered apart from endometrial receptivity. Failure of conception despite repeated transfers of apparently good-quality embryos is a significant clinical problem in practice. This study was conducted to evaluate the efficacy of office hysteroscopy in IVF-ET patients who repeatedly failed to conceive despite transfer of good-quality embryos. Retrospective comparative study. Fifty-six patients who failed to conceive in at least two previous IVF-ET cycles with a normal uterine cavity on hysterosalpingography were included in this study. They were divided into two groups: group A (n=28) had office hysteroscopy and group B (n=28) did not. The main outcome measures were cumulative pregnancy and live birth rates of two IVF-ET cycles following the office hysterosocpy. Total duration between hysteroscopy and following IVF-ET cycles was less than 1 year. The statistical analyses were carried out using SPSS software package and Fisher’s exact or Mann-Whitney U tests were used where appropriate. There were no differences in baseline characteristics and controlled ovarian hyperstimulation (COH) outcomes between the two groups. Pregnancy rate (28.6% vs. 17.9%) and live birth rate (17.6% vs. 10.7%) tended to be higher in group A in the first following cycle after office hysteroscopy. Cumulative pregnancy and live birth rates after two following cycles showed similar results (39.3% vs. 21.4%; 21.4% vs. 14.3%). In group A, abnormal hysteroscopic findings did not have significant effects on the pregnancy rates.View Large Image Figure ViewerDownload (PPT)View Large Image Figure ViewerDownload (PPT)View Large Image Figure ViewerDownload (PPT) Endometrial evaluation with office hysteroscopy in patients who repeatedly failed to conceive seems to improve pregnancy and live birth rates. These results seem to be independent of hysteroscopic uterine findings. Further prospective randomized studies in a larger scale will be necessary to confirm these findings.