Hysteroscopy in women with implantation failures after in vitro fertilization: Findings and effect on subsequent pregnancy rates

ObjectiveTo evaluate the effect of hysteroscopic endometrial cavity evaluation and management prior to IVF in patients with repeated implantation failures.DesignRetrospective cohort study.SettingPrivate assisted reproduction unit.PatientsOne hundred and thirty-two patients with a history of repeated implantation failures despite the transfer of at least three good-quality embryos per transfer.InterventionsHysteroscopy (diagnostic or operative, as appropriate) to evaluate the endometrial cavity followed by repeated IVF/ICSI.Main outcome measuresIncidence of abnormal hysteroscopic findings and the clinical pregnancy rate (CPR) in subsequent IVF cycles.ResultsIn all, 38% of the study population had abnormal hysteroscopic findings and 22.2% of women with abnormal hysteroscopic findings showed a significantly increased CPR in subsequent IVF cycles.ConclusionWomen with repeated implantation failures after IVF have a remarkably high possibility of achieving pregnancy after hysteroscopic evaluation and management of endometrial cavity pathology.