Effectiveness of Laparoscopy and Hysteroscopy to Optimize the Outcome of Assisted Reproductive Technology
Journal of Advances in Medicine and Medical Research,
Background: Identifying the cause of infertility is complex and often reveals overlapping etiologies. Because of the valuable characteristics of hysteroscopy, it has been deemed a promising surgical intervention to improve in vitro fertilization (IVF) outcomes. The present study aimed to evaluate the role and effectiveness of combined laparoscopy and hysteroscopy in the assessment of uterine pathologies in infertile women with recurrent implantation failure (RIF) after IVF, and explore whether removal of such pathologies increased the rate of pregnancy in those women.
Methods: This prospective observational cohort study included 40 infertile patients presented with either primary or secondary infertility after repeated IVF/ intracytoplasmic sperm injection (ICSI) failure. Participants were selected from Endoscopy and Assisted Reproductive units in Obstetrics and Gynecology department at Tanta University Hospital.
Results: There was a statistically significant higher rate of successful cases in the abnormal hysteroscopic findings group. There was no statistically significant difference between normal and abnormal laparoscopic findings groups as regard successful ICSI procedure.
Conclusions: Hysteroscopy is recommended to be a routine diagnostic and therapeutic tool in any case with RIF or recurrent IVF/ICSI failures before a new attempt as it increases the success rate. We can’t recommend routine laparoscopy in any case with RIF or recurrent IVF/ICSI failures.
- assisted reproductive technology
How to Cite
Smith S, Pfeifer SM, Collins JA. Diagnosis and management of female infertility. Jama. 2003;290:1767-70.
Abdallah R, Kligman I. Is there a role for laparoscopy in the diagnosis and treatment of infertility in the 21st century. Middle East Fertility Society Journal. 2010;15: 147-50.
Khatuja R, Mehta S, Rajaram S, Goel G. Role of laparoscopy in infertility: Revisited. Eur J Obstet Gynecol Reprod Biol. 2012;164:118;author reply -9.
Stotz L, Joukhadar R, Hamza A, Thangarajah F, Bardens D, Juhasz-Böss I, et al. Instrument usage in laparoscopic gynecologic surgery: A prospective clinical trial. Arch Gynecol Obstet. 2018;298:773-9.
Jansen FW, Kapiteyn K, Trimbos-Kemper T, Hermans J, Trimbos JB. Complications of laparoscopy: a prospective multicentre observational study. Br J Obstet Gynaecol. 1997;104:595-600.
Tanahatoe S, Hompes PG, Lambalk CB. Accuracy of diagnostic laparoscopy in the infertility work-up before intrauterine insemination. Fertil Steril. 2003;79:361-6.
Pundir J, El Toukhy T. Uterine cavity assessment prior to IVF. Womens Health (Lond). 2010;6:841-7;quiz 7-8.
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;17:410-5.
Elsetohy KA, Askalany AH, Hassan M, Dawood Z. Routine office hysteroscopy prior to ICSI vs. ICSI alone in patients with normal transvaginal ultrasound: A randomized controlled trial. Arch Gynecol Obstet. 2015;291:193-9.
Nelson LM. Primary ovarian insufficiency. New England Journal of Medicine. 2009;360:606-14.
Younis JS. The Bologna criteria for poor ovarian response; has the job been accomplished? Hum Reprod. 2012;27:1874-5;author reply 5-6.
Twijnstra AR, Kolkman W, Trimbos-Kemper GC, Jansen FW. Implementation of advanced laparoscopic surgery in gynecology: national overview of trends. J Minim Invasive Gynecol. 2010;17:487-92.
Loffer FD. Contraindications and complications of hysteroscopy. Obstet Gynecol Clin North Am. 1995;22:445-55.
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.
Dijkhuizen FP, De Vries LD, Mol BW, Brölmann HA, Peters HM, Moret E, et al. Comparison of transvaginal ultrasonography and saline infusion sonography for the detection of intracavitary abnormalities in premenopausal women. Ultrasound Obstet Gynecol. 2000;15:372-6.
Cepni I, Ocal P, Erkan S, Saricali FS, Akbas H, Demirkiran F, et al. Comparison of transvaginal sonography, saline infusion sonography and hysteroscopy in the evaluation of uterine cavity pathologies. Aust N Z J Obstet Gynaecol. 2005;45:30-5.
Al-Temamy E, El-Omda F, Salama S, Salem S, Abd ElRasheed M, Ammar S. Role of routine hysteroscopy in previous failed ICSI: a continuous clinical dilemma. Bulletin of the National Research Centre. 2019;43:1-7.
Al-Turki HA. Hysteroscopy as an investigation tool in recurrent implantation failure In vitro fertilization. Saudi Med J. 2018;39:243-6.
Demirol A, Gurgan T. Effect of treatment of intrauterine pathologies with office hysteroscopy in patients with recurrent IVF failure. Reprod Biomed Online. 2004;8:590-4.
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;274:160-4.
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;387:2614-21.
Yu X, Cai H, Guan J, Zheng X, Han H. Laparoscopic surgery: Any role in patients with unexplained infertility and failed In vitro fertilization cycles? Medicine. 2019;98.
Strandell A, Lindhard A, Waldenström U, Thorburn J. Hydrosalpinx and IVF outcome: cumulative results after salpingectomy in a randomized controlled trial. Hum Reprod. 2001;16:2403-10.
Littman E, Giudice L, Lathi R, Berker B, Milki A, Nezhat C. Role of laparoscopic treatment of endometriosis in patients with failed In vitro fertilization cycles. Fertil Steril. 2005;84:1574-8.
Abstract View: 49 times
PDF Download: 16 times