Značaj histeroskopije u vantelesnom oplođenju

Abstract

Introduction: Pathological states of the uterus cavity, such as endometrial polyp, submucous myoma, intrauterine synechiae or septum, are considered to be negative influence on IVF success. Hysteroscopy is able to diagnose the possible IVF causes of failure and surgically remove them in the same act. Due to frequent cavum pathology, the idea of applying hysteroscopy, even prior to the first IVF, has been seriously considered. Different studies have also stated that the endometrium proinflammatory response after a local endometrial injury can increase the possibility of successful implantation after an embryo transfer in the IVF cycle. Objective: The aim of the project is to determine the frequency of the cavum pathology with patients in IVF process and to examine the impact of hysteroscopy on IVF outcome in cases of post surgical treatment of pathological states of the uterus, with no pathological substratum and after a local endometrial injury. Method: A study group consisted of 114 patients with hysteroscopy performed 30 to 50 days before the IVF cycle. The control group consisted of 151 patients. The local endometrial injury was done in a way not described in any literature available. Results: Having analyzed the obtained results, almost identical pathology frequency was confirmed prior to the first IVF cycle, as with the next, in nearly a third of the cases. Statistically viewed, significantly higher rates of implantation and pregnancies were obtained after hysteroscopy, in comparison to the control group. Probability of a positive IVF outcome rises 2,1 time after a local endometrial injury, when compared to the control group. Conclusion: Hysteroscopy is minimally invasive, safe and simple method providing higher possibility of conceiving after IVF. This research suggests the protocol for IVF preparing couples to be accompanied by obligatory hysteroscopy even prior to the first IVF cycle.