[Systematic hysteroscopy prior to in vitro fertilization].

Area of Science:

• Reproductive Medicine
• Gynecological Surgery
• Infertility Diagnostics

Background:

• Uterine cavity assessment is crucial for successful in vitro fertilization (IVF).
• Diagnostic hysteroscopy offers a direct visualization of the uterine lining.
• Pre-IVF screening protocols aim to optimize implantation rates.

Purpose of the Study:

• To evaluate the diagnostic utility and benefits of hysteroscopy before IVF.
• To determine the prevalence of intrauterine pathologies in infertile patients undergoing IVF.
• To assess the impact of hysteroscopy-guided treatment on IVF pregnancy outcomes.

Main Methods:

• Retrospective study of 145 patients undergoing intracytoplasmic sperm injection (ICSI).
• Systematic office hysteroscopy performed before the initial IVF stimulation cycle.
• Pathological findings were treated medically or surgically prior to embryo transfer.

Main Results:

• Hysteroscopy revealed pathologies in 45% of patients, with endometritis, polyps, and myomas being most common.
• No significant difference in pathology rates was observed between patients over 38 and younger patients.
• Treatment of pathologies resulted in pregnancy rates comparable to those with normal uterine cavities; 40% of endometritis patients conceived post-antibiotic treatment.

Conclusions:

• Systematic pre-IVF hysteroscopy is an effective diagnostic tool.
• Identifying and treating intrauterine pathologies can potentially enhance IVF-ICSI pregnancy rates.
• Hysteroscopy should be considered as part of the routine infertility workup prior to assisted reproductive technologies.