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The role of diagnostic hysteroscopy and endometrial biopsy in assisted reproductive technologies
G B La Sala1, R Montanari, L Dessanti
1Department of Obstetrics and Gynecology, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
Objective:
To study the incidence of unsuspected endouterine abnormalities in patients for whom IVF-ET repeatedly fails.
Design:
Prospective study.
Setting:
Infertility Unit of the Department of Obstetrics and Gynecology, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
Patient(S):
One hundred patients for whom two IVF-ET cycles failed in which > or =2 good-quality embryos were transferred.
Intervention(S):
In-office diagnostic hysteroscopy and endometrial biopsy.
Main Outcome Measure(S):
Relation between IVF-ET failure and unsuspected endouterine abnormalities.
Result(S):
In 18 patients, hysteroscopy showed an important unsuspected endouterine abnormality. Fifteen of these patients did not become pregnant after IVF-ET, and 3 became pregnant but had a spontaneous abortion. Histologic examination of the endometrium revealed chronic endometritis in 1 patient and tuberculous endometritis in another.
Conclusion(S):
Previous studies have reported that the incidence of endouterine abnormalities is high in patients undergoing IVF-ET. Our data confirm the previous reports and lead us to conclude that diagnostic hysteroscopy should be performed on all patients before they undergo IVF-ET.