Hysteroscopic Findings in Patients with A History of Two Implantation Failures Following In Vitro Fertilization

Background: This study was designed to evaluate the incidence of uterine pathologiesin infertile women with a history of two implantation failures after in vitro fertilization(IVF) and estimate the effect of hysteroscopic correction on achieving a pregnancy inthese patients.Materials and Methods: The retrospective study population included 238 infertilewomen attended the outpatient infertility clinic between November 2007 and December2008. Patients with at least two previous IVF failures were eligible for this study.All patients had normal findings on hysterosalpingography performed prior their firstattempt for IVF. Standard transvaginal ultrasonography and diagnostic hysteroscopywere performed in patients before the subsequent IVF attempt.Results: Out of 238 patients with previous IVF failure who underwent hysteroscopicevaluation, 158 patients (66.4%) showed normal uterine cavity. Abnormal cavity wasfound in 80 patients (33.6%). We found polyp as the most common abnormality (19.7%)in the patients with previous history of IVF failure. The pregnancy rate was similar betweenIVF failure patients who treated by hysteroscopy for a detected uterine abnormality(24.6%) and similar patients with normal uterine cavity (21.2%) in hysteroscopicexaminations.Conclusion: The intrauterine lesions diagnosed by hysteroscopy in patients with previousIVF failure ranges from 0.8%-19.7%. Correction of abnormalities such as myoma and polypshowed good outcome, similar to that achieved in patients with a normal hysteroscopy.