In a nutshell
The current study examined whether hysteroscopy could increase the success rates of intracytoplasmic sperm injection.
Some background
A main cause of failure for intracytoplasmic sperm injection (ICSI; a form of in vitro fertilization in which the sperm is injected directly into the egg) is implantation failure, meaning the embryo does not implant in the uterus. Implantation failure can occur due to non-optimal hormone levels, but also can be caused by abnormalities in the uterus itself, such as polyps or myomas (types of growths attached to the uterine wall) or adhesions due to scar tissue. These uterine abnormalities may not be known about by the patient, but could lead to ICSI failure.
Hysteroscopy is a procedure that allows for visualization of the uterus. A camera called a hysteroscope is inserted through the cervix into the uterus to view any abnormalities, which, once seen, can then be corrected. This procedure is not generally done prior to ICSI. The current study examined whether pre-ICSI hysteroscopy increased the success rates of the procedure.
Methods & findings
In this study, 193 ICSI candidates were randomly assigned to two groups. Women in Group 1 underwent a hysteroscopy prior to ICSI, while women in Group 2 did not. Any abnormalities found during hysteroscopy were addressed and treated, if possible, prior to ICSI. Pregnancy rates were compared between the two groups.
43.3% of Group 1 patients had a uterine abnormality diagnosed, the most common being polyps (9.3%) and myomas (7.2%). The pregnancy rate for Group 1 was 70.1%, compared to 45.8% for Group 2. Patients who underwent hysteroscopy were almost three times as likely (2.77) to achieve pregnancy.
The bottom line
This study concluded that hysteroscopy prior to intracytoplasmic sperm injection increases the success rate of the procedure.
Published By :
Archives of Gynecology and Obstetrics
Date :
Aug 01, 2014
