Araştırma Makalesi
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Evaluation of hysteroscopy findings in infertility patients with IVF-ICSI / ET failure

Yıl 2021, Cilt: 46 Sayı: 3, 1168 - 1174, 30.09.2021
https://doi.org/10.17826/cumj.915846

Öz

Purpose: The aim of this study was to determine intrauterine pathologies by hysteroscopy in patients who have undergone IVF-ICSI/ET (in vitro fertilization intracytoplasmic sperm injection / embryo transfer) and have failed, and to classify and evaluate these pathologies.
Materials and Methods: This retrospective study was conducted between 2013 and 2019 at the Reproductive Endocrinology and Infertility Department of Çukurova University Faculty of Medicine, Balcalı Hospital. In this study, patients with primary or secondary infertility diagnosis who applied to the infertility outpatient clinic, who had previously undergone IVF-ICSI / ET and failed and therefore underwent hysteroscopy were included.
Results: The hysteroscopy results of 228 patients included in the study were evaluated. Of these, 42.5% (n = 97) had normal hysteroscopic findings, 57.5% (n = 131) had abnormal hysteroscopic findings. When these abnormal findings were examined, the most common pathology was endometrial polyp 23.1% (n=36). Other findings were; intrauterine synechiae 20.5% (n =32), cervical pathology 18.6% (n =29), cervical stenosis 13.5% (n =21), uterine subseptum 10.9% (n =17), myoma uteri 4.5% (n =7), arcuate uterus 3.2% (n =5), T-shaped uterus 3.2% (n =5), intrauterine infection 1.9% (n =3), and vaginal septum 0.6% (n =1).
Conclusion: Additional investigations for the cause should be performed in patients with implantation failure. The positive effect of hysteroscopy on IVF is related to its detection and treatment of lesions in the endometrial cavity. In addition, hysteroscopy can detect intrauterine pathologies missed by other research methods. Thus, it can contribute positively to the management of patients with IVF failure.

Kaynakça

  • 1. Workup I, Specialist H. Infertility Workup for the Women’s Health Specialist: ACOG Committee Opinion, Number 781. Obstet Gynecol. 2019;133(6):377-84.
  • 2. Coughlan C, Ledger W, Wang Q, Liu F, Demirol A, Gurgan T, et al. Recurrent implantation failure: definition and management. Reprod Biomed Online. 2014; 28:14-38.
  • 3. Bashiri A, Halper KI, Orvieto R. Recurrent Implantation Failure-update overview on etiology, diagnosis, treatment and future directions. Reprod Biol Endocrinol. 2018;16(1):1-18.
  • 4. Orvieto R, Brengauz M, Feldman B. A novel approach to normal responder patient with repeated implantation failures--a case report. Gynecol Endocrinol. 2015;31(6):435-7.
  • 5. Zeyneloglu HB, Onalan G. Remedies for recurrent implantation failure. Semin Reprod Med. 2014;32(4):297-305.
  • 6. Gardner DK, Weissman A, Howles CM and Shoham Z. Text-book of Assisted Reproductive Techniques Volume:2 Clinical Perspectives, Fifth edition, 2018. Part 51: Recurren implantation failure p:662-73.
  • 7. Mascarenhas MN, Flaxman SR, Boerma T, Vanderpoel S, Stevens GA. National, Regional, and Global Trends in Infertility Prevalence Since 1990: A Systematic Analysis of 277 Health Surveys. PLoS Med. 2012;9(12):e1001356.
  • 8. Zegers-Hochschild F, Adamson GD, Dyer S, Racowsky C, De Mouzon J, Sokol R, et al. The International Glossary on Infertility and Fertility Care. Fertil Steril. 2017;108(3):393-406.
  • 9. Speroff L, Glass NH. Clinical Gynecologic Endocrinology and Infertility. 7nd edition. Wolter Kluvwer/Lippincot Williams& Wilkinswer/Lippincot Williams& Wilkins, 2007:84-116.
  • 10. Hoffman B, Schorge JO, Schaffer JI, Halvorson LM, Bradshaw K, Cunningham FG. Williams jinekoloji. Çev. Ed. Yıldırım G. İstanbul: Nobel Tıp Kitabevleri. 2015.
  • 11. Moustafa S, Young SL. Diagnostic and therapeutic options in recurrent implantation failure. F1000Res. 2020;25(9):F1000 Faculty Rev-208.
  • 12. Ovarian Stimulation TEGGO, Bosch E, Broer S, Griesinger G, Grynberg M, Humaidan P, et al. ESHRE guideline: ovarian stimulation for IVF/ICSI†. Hum Reprod Open. 2020;2020(2):hoaa009.
  • 13. Moini A, Kiani K, Ghaffari F, Hosseini F. Hysteroscopic findings in patients with a history of two implantation failures following in vitro fertilization. Int J Fertil Steril. 2012;6(1): 27-30.
  • 14. Kirsop R, Porter R, Torode H, Smith D, Saunders D. The Role of Hysteroscopy in Patients Having Failed IVF/GIFT Transfer Cycles. Aust New Zeal J Obstet Gynaecol. 1991;31(3):263-4.
  • 15. Valle RF. Hysteroscopy in the evaluation of female infertility. Am J Obstet Gynecol. 1980;137(4):425-31.
  • 16. Gaglione R, Paparatti L, Pistilli E. Hysteroscopic diagnosis of uterine intracavitary disorders. Rays. 1998;23(4):655‐61.
  • 17. El-Toukhy T, Campo R, Khalaf Y, Tabanelli C, Gianaroli L, Gordts SS, et al. Hysteroscopy in recurrent in-vitro fertilisation failure (TROPHY): a multicentre, randomised controlled trial. Lancet. 2016;387(10038):2614-21.
  • 18. Mao X, Wu L, Chen Q, Kuang Y, Zhang S. Effect of hysteroscopy before starting in-vitro fertilization for women with recurrent implantation failure: A meta-analysis and systematic review. Medicine (Baltimore). 2019;98(7):e14075.
  • 19. Eshre Workshop. Optimal use of infertility diagnostic tests and treatments. Hum Reprod. 2000;15(3):723-32.
  • 20. Cenksoy P, Ficicioglu C, Yildirim G, Yesiladali M. Hysteroscopic findings in women with recurrent IVF failures and the effect of correction of hysteroscopic findings on subsequent pregnancy rates. Arch Gynecol Obstet. 2013;287(2):357-60.
  • 21. Lorusso F, Ceci O, Bettocchi S, Lamanna G, Costantino, A, Serratì G, et al. Office hysteroscopy in an in vitro fertilization program. Gynecol Endocrinol. 2008;24(8):465-9.
  • 22. Demirol A, Gurgan T. Effect of treatment of intrauterine pathologies with office hysteroscopy in patients with recurrent IVF failure. Reprod Biomed Online. 2004;8(5):590-4.
  • 23. Rama Raju GA, Shashi Kumari G, Krishna KM, Prakash GJ, Madan K. Assessment of uterine cavity by hysteroscopy in assisted reproduction programme and its influence on pregnancy outcome. Arch Gynecol Obstet. 2006;274(3):160-4.
  • 24. Taylor E, Gomel V. The uterus and fertility. Fertil Steril. 2008;89(1):1-16.
  • 25. Bozdag G, Aksan G, Esinler I, Yarali H. What is the role of office hysteroscopy in women with failed IVF cycles? Reprod Biomed Online. 2008;17(3):410-5.
  • 26. Al-Turki HA. Hysteroscopy as an investigation tool in recurrent implantation failure in vitro fertilization. Saudi Med J. 2018;39(3):243-6.
  • 27. Aletebi F. Hysteroscopy in women with implantation failures after in vitro fertilization: Findings and effect on subsequent pregnancy rates. Middle East Fertil Soc J. 2010;15(4):288-91.
  • 28. Seval MM, Sükür YE, Özmen B, Kan Ö, Sönmezer M, Berker B, et al. Does adding endometrial scratching to diagnostic hysteroscopy improve pregnancy rates in women with recurrent in-vitro fertilization failure. Gynecol Endocrinol. 2016;32(12):957–60.

IVF-ICSI/ET başarısızlığı olan infertil hastalarda histeroskopi bulgularının değerlendirilmesi

Yıl 2021, Cilt: 46 Sayı: 3, 1168 - 1174, 30.09.2021
https://doi.org/10.17826/cumj.915846

Öz

fertilizasyon-intrastoplazmik sperm injeksiyonu/embriyo transferi) yapılmış ve başarısız olunmuş hastalarda histeroskopi ile intrauterin patolojileri saptamak ve bu patolojileri sınıflandırıp değerlendirilmesidir.
Gereç ve Yöntem: Bu retrospektif çalışma 2013-2019 yılları arasında Çukurova Üniversitesi Tıp Fakültesi Balcalı Hastanesi Üreme Endokrinolojisi ve İnfertilite Bölümü’nde yapılmıştır. Bu çalışmaya, infertilite polikliniği’ne başvuran primer veya sekonder infertilite tanılı, daha önceden IVF-ICSI/ET yapılıp başarısızlıkla sonuçlanan ve bu nedenle histeroskopi uygulanan hastalar dahil edilmiştir.
Bulgular: Çalışmaya alınan 228 hastanın histeroskopi sonuçları değerlendirildi. Bunlardan, %42,5’i (n=97) normal histeroskopik bulgulara, %57,5’i (n=131) anormal histeroskopik bulgulara sahipti. Bu anormal bulgular incelendiğinde, en sık izlenen patoloji endometrial polip %23,1 (n=36) idi. Diğer bulgular; intrauterin sineşi %20,5 (n=32), servikal patoloji %18,6 (n=29), servikal stenoz %13,5 (n=21), uterin subseptum %10,9 (n=17), myoma uteri %4,5 (n=7), arkuat uterus %3,2 (n=5), T-shape uterus %3,2 (n=5), intrauterin enfeksiyon %1,9 (n=3) ve vajinal septum %0,6 (n=1) idi.
Sonuç: İmplantasyon başarısızlığı olan hastalarda nedene yönelik ek incelemeler yapılmalıdır. Histeroskopinin IVF üzerine olan pozitif etkisi endometrial kavitedeki lezyonları saptama ve tedavi etmesi ile ilişkilidir. Ayrıca histeroskopi, diğer araştırma yöntemleri tarafından gözden kaçırılan intrauterin patolojileri saptayabilir. Böylece IVF başarısızlığı olan hastaların yönetimine olumlu katkı sağlayabilir.

Kaynakça

  • 1. Workup I, Specialist H. Infertility Workup for the Women’s Health Specialist: ACOG Committee Opinion, Number 781. Obstet Gynecol. 2019;133(6):377-84.
  • 2. Coughlan C, Ledger W, Wang Q, Liu F, Demirol A, Gurgan T, et al. Recurrent implantation failure: definition and management. Reprod Biomed Online. 2014; 28:14-38.
  • 3. Bashiri A, Halper KI, Orvieto R. Recurrent Implantation Failure-update overview on etiology, diagnosis, treatment and future directions. Reprod Biol Endocrinol. 2018;16(1):1-18.
  • 4. Orvieto R, Brengauz M, Feldman B. A novel approach to normal responder patient with repeated implantation failures--a case report. Gynecol Endocrinol. 2015;31(6):435-7.
  • 5. Zeyneloglu HB, Onalan G. Remedies for recurrent implantation failure. Semin Reprod Med. 2014;32(4):297-305.
  • 6. Gardner DK, Weissman A, Howles CM and Shoham Z. Text-book of Assisted Reproductive Techniques Volume:2 Clinical Perspectives, Fifth edition, 2018. Part 51: Recurren implantation failure p:662-73.
  • 7. Mascarenhas MN, Flaxman SR, Boerma T, Vanderpoel S, Stevens GA. National, Regional, and Global Trends in Infertility Prevalence Since 1990: A Systematic Analysis of 277 Health Surveys. PLoS Med. 2012;9(12):e1001356.
  • 8. Zegers-Hochschild F, Adamson GD, Dyer S, Racowsky C, De Mouzon J, Sokol R, et al. The International Glossary on Infertility and Fertility Care. Fertil Steril. 2017;108(3):393-406.
  • 9. Speroff L, Glass NH. Clinical Gynecologic Endocrinology and Infertility. 7nd edition. Wolter Kluvwer/Lippincot Williams& Wilkinswer/Lippincot Williams& Wilkins, 2007:84-116.
  • 10. Hoffman B, Schorge JO, Schaffer JI, Halvorson LM, Bradshaw K, Cunningham FG. Williams jinekoloji. Çev. Ed. Yıldırım G. İstanbul: Nobel Tıp Kitabevleri. 2015.
  • 11. Moustafa S, Young SL. Diagnostic and therapeutic options in recurrent implantation failure. F1000Res. 2020;25(9):F1000 Faculty Rev-208.
  • 12. Ovarian Stimulation TEGGO, Bosch E, Broer S, Griesinger G, Grynberg M, Humaidan P, et al. ESHRE guideline: ovarian stimulation for IVF/ICSI†. Hum Reprod Open. 2020;2020(2):hoaa009.
  • 13. Moini A, Kiani K, Ghaffari F, Hosseini F. Hysteroscopic findings in patients with a history of two implantation failures following in vitro fertilization. Int J Fertil Steril. 2012;6(1): 27-30.
  • 14. Kirsop R, Porter R, Torode H, Smith D, Saunders D. The Role of Hysteroscopy in Patients Having Failed IVF/GIFT Transfer Cycles. Aust New Zeal J Obstet Gynaecol. 1991;31(3):263-4.
  • 15. Valle RF. Hysteroscopy in the evaluation of female infertility. Am J Obstet Gynecol. 1980;137(4):425-31.
  • 16. Gaglione R, Paparatti L, Pistilli E. Hysteroscopic diagnosis of uterine intracavitary disorders. Rays. 1998;23(4):655‐61.
  • 17. El-Toukhy T, Campo R, Khalaf Y, Tabanelli C, Gianaroli L, Gordts SS, et al. Hysteroscopy in recurrent in-vitro fertilisation failure (TROPHY): a multicentre, randomised controlled trial. Lancet. 2016;387(10038):2614-21.
  • 18. Mao X, Wu L, Chen Q, Kuang Y, Zhang S. Effect of hysteroscopy before starting in-vitro fertilization for women with recurrent implantation failure: A meta-analysis and systematic review. Medicine (Baltimore). 2019;98(7):e14075.
  • 19. Eshre Workshop. Optimal use of infertility diagnostic tests and treatments. Hum Reprod. 2000;15(3):723-32.
  • 20. Cenksoy P, Ficicioglu C, Yildirim G, Yesiladali M. Hysteroscopic findings in women with recurrent IVF failures and the effect of correction of hysteroscopic findings on subsequent pregnancy rates. Arch Gynecol Obstet. 2013;287(2):357-60.
  • 21. Lorusso F, Ceci O, Bettocchi S, Lamanna G, Costantino, A, Serratì G, et al. Office hysteroscopy in an in vitro fertilization program. Gynecol Endocrinol. 2008;24(8):465-9.
  • 22. Demirol A, Gurgan T. Effect of treatment of intrauterine pathologies with office hysteroscopy in patients with recurrent IVF failure. Reprod Biomed Online. 2004;8(5):590-4.
  • 23. Rama Raju GA, Shashi Kumari G, Krishna KM, Prakash GJ, Madan K. Assessment of uterine cavity by hysteroscopy in assisted reproduction programme and its influence on pregnancy outcome. Arch Gynecol Obstet. 2006;274(3):160-4.
  • 24. Taylor E, Gomel V. The uterus and fertility. Fertil Steril. 2008;89(1):1-16.
  • 25. Bozdag G, Aksan G, Esinler I, Yarali H. What is the role of office hysteroscopy in women with failed IVF cycles? Reprod Biomed Online. 2008;17(3):410-5.
  • 26. Al-Turki HA. Hysteroscopy as an investigation tool in recurrent implantation failure in vitro fertilization. Saudi Med J. 2018;39(3):243-6.
  • 27. Aletebi F. Hysteroscopy in women with implantation failures after in vitro fertilization: Findings and effect on subsequent pregnancy rates. Middle East Fertil Soc J. 2010;15(4):288-91.
  • 28. Seval MM, Sükür YE, Özmen B, Kan Ö, Sönmezer M, Berker B, et al. Does adding endometrial scratching to diagnostic hysteroscopy improve pregnancy rates in women with recurrent in-vitro fertilization failure. Gynecol Endocrinol. 2016;32(12):957–60.
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm Araştırma
Yazarlar

Lena Türeyici 0000-0003-1075-2292

Bekir Kahveci 0000-0002-8729-1669

İbrahim Ferhat Ürünsak 0000-0002-4056-6434

Yayımlanma Tarihi 30 Eylül 2021
Kabul Tarihi 7 Temmuz 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 46 Sayı: 3

Kaynak Göster

MLA Türeyici, Lena vd. “IVF-ICSI/ET başarısızlığı Olan Infertil Hastalarda Histeroskopi bulgularının değerlendirilmesi”. Cukurova Medical Journal, c. 46, sy. 3, 2021, ss. 1168-74, doi:10.17826/cumj.915846.