Hysteroscopy in women with implantation failures after in vitro fertilization: Findings and effect on subsequent pregnancy rates

Objective: To evaluate the effect of hysteroscopic endometrial cavity evaluation and management prior to IVF in patients with repeated implantation failures. Design: Retrospective cohort study. Setting: Private assisted reproduction unit. Patients: One hundred and thirty-two patients with a history of repeated implantation failures despite the transfer of at least three good-quality embryos per transfer. Interventions: Hysteroscopy (diagnostic or operative, as appropriate) to evaluate the endometrial cavity followed by repeated IVF/ICSI. Main outcome measures: Incidence of abnormal hysteroscopic findings and the clinical pregnancy rate (CPR) in subsequent IVF cycles. Results: In all, 38% of the study population had abnormal hysteroscopic findings and 22.2% of women with abnormal hysteroscopic findings showed a significantly increased CPR in subsequent IVF cycles. Conclusion: Women with repeated implantation failures after IVF have a remarkably high possibility of achieving pregnancy after hysteroscopic evaluation and management of endometrial cavity pathology. (C) 2010 Middle East Fertility Society. Production and Hosting by Elsevier B.V. All rights reserved.