The prevelance of abnormal hysteroscopic finding among 90 infertile patiens

Abstract EN

Introduction : Although numerous advances in the field 0؛ ART, implantation failure occur frequently in spite transfer of good quality embryos, repeated implantation failure may be because at reduced endc-metrial receptivity, embryonic defect or multifactorial causes.

Hysteroscopy is considered the gold standard for identification and treatment of intrauterine pathology. Material and Methods: prospective study of 90 infertile patients scheduled for ICSI, (10 cases) hysteroscopy done during period, February 2008 to June 2009 at A1-Hussein University Hospital (20 cases) and Eshraque IVF Center (70 cases). Results : Out of the 90 women scheduled for ICSI, 53 women (58.89°/ه), abnormal hysteroscopic findings detected, endometrial polyps 30 cases (33.33°/©), submucous myoma 9 cases (ه/°0ا), intrauterine synaechia 5 cases (5.55), and uterine septum 3 cases (3.33ه/م).

Cases with abnormal hysteroscopic findings, underwent operative interference, polypectomy using forceps for endometrial polyp, myomectomy using resectoscope for submucous myoma, division of intrauterine synaechia using scissor for IUS and division of uterine septum using resectoscope for uterine septum.

Out of 51 cases underwent ICSI after hysteroscopy, 16 'cases (31.37°/©) got pregnant and out of 16 cases with previous failed implantation and underwent ICSI after hysteroscopy 5 cases (31.25%) got pregnant.

Conclusion: The hysteroscopy is considered the gold standard for identification and treatment of intrauterine pathology that may be responsible for failure of ICSI, resulting in improved pregnancy rate and also save the patients additional cost of another ICSI cycle, this specially true in women with previous failed ICSI. Transvaginal sonography may be used as initial diagnostic procedure to select patients for hysteroscopy.

HSG has high sensitivity (81-98ه/ه) but low specificity (23-35%) and high false-negative (ه/ه90-0ا) and false-positive (22-44°/ه) rates.