Intracytoplasmic Sperm Injection Clinical Trial
Official title:
Pregnancy Rate in Women With Normal Uterine Cavity and Those With Corrected Uterine Lesions in ICSI Cycles
The aim of the current study is to investigate the pregnancy rate in women with normal uterine cavity and those detected or corrected uterine cavitary lesions, assessed by hysteroscopy in ICSI cycles.
Intrauterine pathology has been reported in up to 25% of infertile women having IVF treatment
and in as many as 50% of women with recurrent implantation failure, leading to suggestions
that correction of such pathology could improve treatment outcome. Hysteroscopy allows visual
assessment of the cervical canal and uterine cavity and provides the opportunity to operate
in the same setting. Routine outpatient hysteroscopy before starting IVF has been postulated
to diagnose and treat abnormalities of the cervix and uterine cavity and hence improve IVF
outcome.
A systematic review of published studies suggested that outpatient hysteroscopy in the
menstrual cycle preceding an IVF treatment cycle could significantly increase the clinical
pregnancy rate in women who had previously had recurrent implantation failure, even when no
hysteroscopic abnormality was detected.
However, the result of the TROPHY study - published in the Lancet in 2016 concluded that
Outpatient hysteroscopy before IVF in women with a normal ultrasound of the uterine cavity
and a history of unsuccessful IVF treatment cycles does not improve the livebirth rate and
they recommended that further research into the effectiveness of surgical correction of
specific uterine cavity abnormalities before IVF is warranted.
An MD thesis done in our department on the evaluation of the endometrial cavity in infertile
patients and prior to IVF recommended that there is an urgent need to RCT to emphasize the
benefit of removal of the detected intrauterine lesions before proceeding to IVF.
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