Hysteroscopy in Patients with Normal Transvaginal Ultrasound Prior to IVF: A Randomized Controlled Trial

                                        Austin Journal of Reproductive Medicine & Infertility

InVitro Fertilization (IVF) treatment is used widely for women who have had difficulty conceiving. Nowadays more than 700000 treatment cycles were given in the USA and Europe alone and the number is expanding steadily worldwide. Despite numerous improvements in assisted reproductive techniques, only 30% of cycles of IVF lead to the birth of a child. IVF is an expensive treatment and implantation failure could be due to a variety of reasons, including embryo quality and uterine receptivity, but remains unexplained in many cases.

Accordingto several studies the most frequent cause of Implantation Failure (IF) is the presence of chromosomal abnormalities in the embryo. However, abnormalities of the uterine cavity such as myomas, polyps and adhesions are also related with impaired implantation and reduced chance of pregnancy. Approximately 25% of infertile patients have defects in uterine cavity and abnormal uterine findings are reported in about 50% of women with recurrent implantation failure. Hysteroscopy is considered the reference standard to detect these uterine disorders. It has been suggested that these abnormalities should be diagnosed and treated to optimize the condition of the uterine environment and the outcome of IVF treatment. Moreover, hysteroscopy could improve pregnancy rates through dilatation of the cervical canal to favour embryo transfer as well as through the induction of an inflammatory reaction of the endometrium with the procedure.