Does the time interval between diagnostic hysteroscopy with endometrial biopsy and embryo transfer affect pregnancy outcome?
Abstract
Aim: The effectiveness of diagnostic hysteroscopy and endometrial injury prior to the in vitro fertilization cycle has been examined in several studies with conflicting results. The optimal time interval for the procedures and the technique for endometrial injury have not described yet. The aim of this study is to investigate the effect of the time interval between hysteroscopy/endometrial biopsy procedure and embryo transfer on reproductive outcomes.
Materials and Methods: Patients who underwent diagnostic H/S and endometrial biopsy procedure prior to the in vitro fertilization cycle, between 2016-2018 years, were retrospectively analyzed. Patients were divided into 5 groups according to the time interval between the procedures. Reproductive outcomes as clinical pregnancy rates, pregnancy loss rates, and live birth rates of the groups were analyzed.
Results: A total of 252 patients were included to the analysis and 49.2% consisted of patients with repeated implantation failure. Totally 29% of the embryo transfer cycle was performed after one 1 month, 32% after 2 months, 17.5% after 3-4 months, 12% after 5-6 months and 9.5% after more than 6 months of the hysteroscopy/endometrial biopsy procedure. The baseline characteristics were not different between the groups. The clinical pregnancy (34.2%, 35.8%, 31.8%, 40% and 37.5%, respectively), pregnancy loss rate (%8.2, %8.6, %9.1, %13.3 ve %8.3) and live birth rates (26%, 27.2%, 22.7%, 26.7% and 29.2%, respectively) were similar of the groups.
Conclusion: There is no significant difference in reproductive outcomes according to the time interval between diagnostic hysteroscopy/endometrial biopsy and embryo transfer procedures. Performing IVF-embryo transfer in the next menstrual cycle or later may not affect the outcomes.
References
- Pundir J, El Toukhy T. Uterine cavity assessment prior to IVF. Womens Health (Lond). 2010 Nov; 6 (6): 841-7
- Di Spiezio Sardo A, Di Carlo C, Minozzi S, et al. Efficacy of hysteroscopy in improving reproductive outcomes of infertile couples: a systematic review and meta-analysis. Hum Reprod Update. 2016 Jun; 22 (4): 479-96.
- Pundir J, Pundir V, Omanwa K, Khalaf Y, El-Toukhy T. Hysteroscopy prior to the first IVF cycle: a systematic review and meta-analysis. Reprod Biomed Online. 2014 Feb; 28 (2): 151-61.
- Cao H, You D, Yuan M, Xi M. Hysteroscopy after repeated implantation failure of assisted reproductive technology: A meta-analysis. J Obstet Gynaecol Res. 2018 Mar; 44 (3): 365-73.
- Kamath MS, Bosteels J, D'Hooghe TM, et al. Screening hysteroscopy in subfertile women and women undergoing assisted reproduction. Cochrane Database Syst Rev. 2019 Apr 16; 4: CD012856.
- Nastri CO, Lensen SF, Gibreel A, et al. Endometrial injury in women undergoing assisted reproductive techniques. Cochrane Database Syst Rev. 2015 Mar 22; (3): CD009517.
- Van Hoogenhuijze NE, Kasius JC, Broekmans FJM, Bosteels J, Torrance HL . Endometrial scratching prior to IVF; does it help and for whom? A systematic review and meta-analysis. Hum Reprod Open. 2019 Jan 29; 2019 (1): hoy025.
- Sar-Shalom Nahshon C, Sagi-Dain L, Wiener-Megnazi Z, Dirnfeld M. The impact of intentional endometrial injury on reproductive outcomes: a systematic review and meta-analysis. Hum Reprod Update. 2019 Jan 1; 25 (1): 95-113.Cilt 60 Sayı 1, Mart 2021 / Volume 60 Issue 1, March 2021 57
- Nahshon C, Sagi-Dain L, Dirnfeld M. The impact of endometrial injury on reproductive outcomes: results of an updated meta-analysis. Reprod Med Biol. 2020 Sep 17; 19 (4): 334-49.
- Siristatidis C, Vrachnis N, Vogiatzi P, et al. Potential pathophysiological mechanisms of the beneficial role of endometrial injury in in vitro fertilization outcome. Reprod Sci. 2014 Aug; 21 (8):955-65.
- Gnainsky Y, Granot I, Aldo PB, et al. Local injury of the endometrium induces an inflammatory response that promotes successful implantation. Fertil Steril. 2010 Nov; 94 (6): 2030-6.
- Bar G, Harlev A, Alfayumi-Zeadna S, Zeadna A, Bord I, Har-Vardi I, Lunenfeld E, Levitas E. Recurrent implantation failure: which patients benefit from endometrial scratching prior to IVF? Arch Gynecol Obstet. 2020 Mar;301(3):817-22.
- Pabuçcu EG, Yalçın İ, Bodur T, Çağlar GS, Pabuçcu R. Impact of Office hysteroscopy in repeated implantation failure: Experience of a single center. J Turk Ger Gynecol Assoc. 2016 Dec 1; 17 (4): 197-200.
- Hosseini MA, Ebrahimi N, Mahdavi A, et al. Hysteroscopy in patients with repeated implantation failure improves the outcome of assisted reproductive technology in fresh and frozen cycles. J Obstet Gynaecol Res. 2014 May; 40 (5): 1324-30.
- Kilic Y, Bastu E, Ergun B. Validity and efficacy of Office hysteroscopy before in vitro fertilization treatment. Arch Gynecol Obstet. 2013 Mar; 287 (3): 577-81.
- Gao M, Sun Y, Xie H, Fang S, Zhao X. Hysteroscopy prior to repeat embryo transfer may improve pregnancy outcomes for asymptomatic women with repeated implantation failure. J Obstet Gynaecol Res 2015; 41: 1569-76.
- 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 Sep;17 (3): 410-5.
- Smit JG, Kasius JC, Eijkemans MJC, et al. Hysteroscopy before in-vitro fertilisation (inSIGHT): a multicentre, randomised controlled trial. Lancet. 2016 Jun 25; 387 (10038): 2622-29.
- El-Toukhy T, Campo R, Khalaf Y, et al. Hysteroscopy in recurrent in-vitro fertilisation failure (TROPHY): a multicentre, randomised controlled trial. Lancet. 2016 Jun 25; 387 (10038): 2614-21.
- Gürgan T, Kalem Z, Kalem MN, Ruso H, Benkhalifa M, Makrigiannakis A. Systematic and standardized hysteroscopic endometrial injury for treatment of recurrent implantation failure. Reprod Biomed Online. 2019 Sep; 39 (3): 477-83.
- Siristatidis C, Kreatsa M, Koutlaki N, Galazios G, Pergialiotis V, Papantoniou N. Endometrial injury for RIF patients undergoing IVF/ICSI: a prospective nonrandomized controlled trial. Gynecol Endocrinol. 2017 Apr; 33 (4): 297-300.
- Seval MM, Şükür YE, Özmen B, et al. Does adding endometrial scratching to diagnostic hysteroscopy improve pregnancy rates in women with recurrent in-vitro fertilization failure? Gynecol Endocrinol. 2016 Dec; 32 (12): 957-60.
- Berntsen S, Hare KJ, Løssl K, Bogstad J, Palmø J, Prætorius L, Zedeler A, Pinborg A. Endometrial scratch injury with office hysteroscopy before IVF/ICSI: A randomised controlled trial. Eur J Obstet Gynecol Reprod Biol. 2020 Sep; 252: 112-7.
- Pereire N, Amrane S, Estes JL, et al. Does the time interval between hysteroscopic polypectomy and start of in vitro fertilization affect outcomes? Fertil Steril. 2016 Feb; 105 (2): 539-44.
Diagnostik histeroskopi ve endometrial biyopsi ile embriyo transferi arası geçen süre gebelik sonuçları üzerine etkili midir?
Abstract
Amaç: In vitro fertilizasyon öncesi diagnostik histeroskopi ve endometrial hasar oluşturmanın etkinliği birçok çalışmada araştırılmıştır ve sonuçlar tartışmalıdır. Prosedürler arası optimal zaman aralığı ve optimal endometrial hasar oluşturma tekniği de net olarak tanımlanmamıştır. Bu çalışmanın amacı histeroskopi/endometrial biyopsi ile embriyo transferi arası zaman aralığının reprodüktif sonuçlar üzerine etkisini araştırmaktır.
Gereç ve Yöntem: 2016-2018 yılları arasında, in vitro fertilizasyon siklusu öncesinde diagnostik histeroskopiyle birlikte endometrial biyopsi yapılan olgular retrospektif olarak analiz edildi. Hastalar prosedürler arası süreye göre beş gruba ayrıldı. Grupların reprodüktif sonuçları olarak klinik gebelik, gebelik kaybı ve canlı doğum oranları analiz edildi.
Bulgular: Toplamda 252 hasta analize alındı, %49,2’si tekrarlayan implantasyon başarısızlığı olan olguları içeriyordu. Embriyo transfer siklusu olguların %29’unda histeroskopi/endometrial biyopsi prosedüründen 1 ay sonra, %32’sinde 2 ay sonra, %17,5’unda 3-4 ay sonra, %12’sinde 5-6 ay sonra ve %9,5’unda 6 aydan daha geç sürede uygulandı. Grupların temel karakteristikleri farklılık göstermiyordu. Grupların klinik gebelik (%34,2, %35,8, %31,8, %40 ve %37,5), gebelik kaybı (%8,2, %8,6, %9,1, %13,3 ve %8,3) ve canlı doğum oranları (%26, %27,2, %22,7, %26,7 ve %29,2) benzer olarak saptandı.
Sonuç: Diagnostik histeroskopi/endometrial biyopsi ile embriyo transfer uygulaması arası geçen süre açısından reprodüktif sonuçlarda bir farklılık bulunmamaktadır. IVF-embriyo transferini ertesi menstrüel siklusta veya daha geç yapmak sonuçları etkilemeyebilir.
References
- Pundir J, El Toukhy T. Uterine cavity assessment prior to IVF. Womens Health (Lond). 2010 Nov; 6 (6): 841-7
- Di Spiezio Sardo A, Di Carlo C, Minozzi S, et al. Efficacy of hysteroscopy in improving reproductive outcomes of infertile couples: a systematic review and meta-analysis. Hum Reprod Update. 2016 Jun; 22 (4): 479-96.
- Pundir J, Pundir V, Omanwa K, Khalaf Y, El-Toukhy T. Hysteroscopy prior to the first IVF cycle: a systematic review and meta-analysis. Reprod Biomed Online. 2014 Feb; 28 (2): 151-61.
- Cao H, You D, Yuan M, Xi M. Hysteroscopy after repeated implantation failure of assisted reproductive technology: A meta-analysis. J Obstet Gynaecol Res. 2018 Mar; 44 (3): 365-73.
- Kamath MS, Bosteels J, D'Hooghe TM, et al. Screening hysteroscopy in subfertile women and women undergoing assisted reproduction. Cochrane Database Syst Rev. 2019 Apr 16; 4: CD012856.
- Nastri CO, Lensen SF, Gibreel A, et al. Endometrial injury in women undergoing assisted reproductive techniques. Cochrane Database Syst Rev. 2015 Mar 22; (3): CD009517.
- Van Hoogenhuijze NE, Kasius JC, Broekmans FJM, Bosteels J, Torrance HL . Endometrial scratching prior to IVF; does it help and for whom? A systematic review and meta-analysis. Hum Reprod Open. 2019 Jan 29; 2019 (1): hoy025.
- Sar-Shalom Nahshon C, Sagi-Dain L, Wiener-Megnazi Z, Dirnfeld M. The impact of intentional endometrial injury on reproductive outcomes: a systematic review and meta-analysis. Hum Reprod Update. 2019 Jan 1; 25 (1): 95-113.Cilt 60 Sayı 1, Mart 2021 / Volume 60 Issue 1, March 2021 57
- Nahshon C, Sagi-Dain L, Dirnfeld M. The impact of endometrial injury on reproductive outcomes: results of an updated meta-analysis. Reprod Med Biol. 2020 Sep 17; 19 (4): 334-49.
- Siristatidis C, Vrachnis N, Vogiatzi P, et al. Potential pathophysiological mechanisms of the beneficial role of endometrial injury in in vitro fertilization outcome. Reprod Sci. 2014 Aug; 21 (8):955-65.
- Gnainsky Y, Granot I, Aldo PB, et al. Local injury of the endometrium induces an inflammatory response that promotes successful implantation. Fertil Steril. 2010 Nov; 94 (6): 2030-6.
- Bar G, Harlev A, Alfayumi-Zeadna S, Zeadna A, Bord I, Har-Vardi I, Lunenfeld E, Levitas E. Recurrent implantation failure: which patients benefit from endometrial scratching prior to IVF? Arch Gynecol Obstet. 2020 Mar;301(3):817-22.
- Pabuçcu EG, Yalçın İ, Bodur T, Çağlar GS, Pabuçcu R. Impact of Office hysteroscopy in repeated implantation failure: Experience of a single center. J Turk Ger Gynecol Assoc. 2016 Dec 1; 17 (4): 197-200.
- Hosseini MA, Ebrahimi N, Mahdavi A, et al. Hysteroscopy in patients with repeated implantation failure improves the outcome of assisted reproductive technology in fresh and frozen cycles. J Obstet Gynaecol Res. 2014 May; 40 (5): 1324-30.
- Kilic Y, Bastu E, Ergun B. Validity and efficacy of Office hysteroscopy before in vitro fertilization treatment. Arch Gynecol Obstet. 2013 Mar; 287 (3): 577-81.
- Gao M, Sun Y, Xie H, Fang S, Zhao X. Hysteroscopy prior to repeat embryo transfer may improve pregnancy outcomes for asymptomatic women with repeated implantation failure. J Obstet Gynaecol Res 2015; 41: 1569-76.
- 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 Sep;17 (3): 410-5.
- Smit JG, Kasius JC, Eijkemans MJC, et al. Hysteroscopy before in-vitro fertilisation (inSIGHT): a multicentre, randomised controlled trial. Lancet. 2016 Jun 25; 387 (10038): 2622-29.
- El-Toukhy T, Campo R, Khalaf Y, et al. Hysteroscopy in recurrent in-vitro fertilisation failure (TROPHY): a multicentre, randomised controlled trial. Lancet. 2016 Jun 25; 387 (10038): 2614-21.
- Gürgan T, Kalem Z, Kalem MN, Ruso H, Benkhalifa M, Makrigiannakis A. Systematic and standardized hysteroscopic endometrial injury for treatment of recurrent implantation failure. Reprod Biomed Online. 2019 Sep; 39 (3): 477-83.
- Siristatidis C, Kreatsa M, Koutlaki N, Galazios G, Pergialiotis V, Papantoniou N. Endometrial injury for RIF patients undergoing IVF/ICSI: a prospective nonrandomized controlled trial. Gynecol Endocrinol. 2017 Apr; 33 (4): 297-300.
- Seval MM, Şükür YE, Özmen B, et al. Does adding endometrial scratching to diagnostic hysteroscopy improve pregnancy rates in women with recurrent in-vitro fertilization failure? Gynecol Endocrinol. 2016 Dec; 32 (12): 957-60.
- Berntsen S, Hare KJ, Løssl K, Bogstad J, Palmø J, Prætorius L, Zedeler A, Pinborg A. Endometrial scratch injury with office hysteroscopy before IVF/ICSI: A randomised controlled trial. Eur J Obstet Gynecol Reprod Biol. 2020 Sep; 252: 112-7.
- Pereire N, Amrane S, Estes JL, et al. Does the time interval between hysteroscopic polypectomy and start of in vitro fertilization affect outcomes? Fertil Steril. 2016 Feb; 105 (2): 539-44.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | March 31, 2021 |
| Submission Date | August 7, 2020 |
| Published in Issue | Year 2021Volume: 60 Issue: 1 |
