AI Summary & Key Takeaways
AI InsightConclusion: To improve the outcome of ART cycles, OH could be performed as a routine procedure for the patients who will experience IVF treatment.
📌 3 Key Takeaways
Abstract
Objective: To evaluate the intrauterine pathologies using office-based hysteroscopy (OH) in patients scheduled for assisted reproductive technologies (ART). Materials and Methods: This study was conducted at the In Vitro Fertilization (IVF) Unit of Firat University Hospital, between March 2010- January 2012. The 219 patients with no OH within the previous 6 months were enrolled the study with rigid hysteroscope (continous flow; 30-degree forward-oblique view) assembled in a 4-mm diameter diagnostic sheath with an atraumatic tip. After OH investigation, endometrial sampling was performed with biopsy catheter. The patients in whom the findings were normal proceeded to an IVF cycle within 1 month. Results: The procedure was succesful in 219 patients, with mean (±SD) age of 31.9 (±5.2) years, duration of infertility of 6.2 (±4.5) years and number of previous ART trials 1.6 (±1.1). The type of infertility were as follows: 150 primary (68.5%) and 69 secondary infertility (31.5%). Endometrial polyp and uterine subseptum were the major intracavitary abnormalities. Chronic endometritis and endometrial polyp were the major histopathologic abnormalities. Chronic endometritis, uterine subseptum and endometrial hyperplasia were higher in patients ≥35 years (p<0.01). There was a decrease in the pregnancy rate (40% vs 46%), implantation rate (51% vs 56%) and fertilization rate (69% vs 74%) in the patients with hysteroscopic abnorma- lity compared to patients without abnormality respectively. Conclusion: To improve the outcome of ART cycles, OH could be performed as a routine procedure for the patients who will experience IVF treatment.
Özet
Amaç: Çalışmamızda invitro fertilizasyon (IVF) tedavisi programına alınmış hastalarda ofis histeroskopi (OH) ile saptanacak intrauterin patolojileri ortaya çıkarmayı amaçladık. Gereç ve Yöntem: Bu retrospektif çalışmaya Fırat Üniversitesi Hastanesi IVF Ünitesi’nde Mart 2010- Ocak 2012 tarihleri arasında tüp bebek prog- ramına alınan ve OH yapılan 219 hasta dahil edildi. Rijid, 30 derece ileri oblik görüşlü-sürekli akımlı, 4mm çaplı, diagnostik histeroskop son 6 ayda ve daha önce OH yapılmamış hastalara uygulandı. OH takiben biyopsi kateteri ile endometrial örnekleme yapıldı. Bulguları normal olan hastalar takip eden 1 ay içinde IVF siklusuna alındı. Bulgular: Hastaların ortalama yaşı 31.9 (±5.2) yıl, infertilite süresi 6.2 (±4.5) yıl ve daha önceki IVF deneme sayısı 1.6 (±1.1) adet idi. Hastaların %68.5’i primer infertil, %31.5’i sekonder infertil idi. İntrakaviter major anomaliler uterin subseptum ve endometrial polip idi. Histopatolojik major bulgular kronik endometrit ve endometrial hiperplazi idi. Kronik endometrit, uterin subseptum ve endometrial hiperplazi patolojileri 35 yaş üstü hastalarda daha fazla idi (p<0.01). Histeroskopik patoloji saptanan hastalarda gebelik oranı (%40 vs %46), implantasyon oranı (%51 vs %56) ve fertilizasyon oranı (%69 vs %74) histeroskopik patoloji saptanmayanlara göre daha düşük gözlendi. Sonuç: IVF siklusuna alınacak hastalarda tedavi başarısını artırabilmek için OH rutin bir prosedür olarak uygulanabilir.