I-23: The Role of Hysteroscopy in Patients with Repeated IVF Failure

The success of reproduction, although gradually increasing over the years, many couples also had been left frustrated following repeated failed attempts. Implantation of the embryo, can only take place in a receptive uterus and inadequate uterine receptivity is responsible for approximately two-thirds of implantation failures. Endometrial receptivity can be reduced by morphological and/or molecular variables. Endometrial morphological irregularity like uterine polyps, septa, leiomyomata and adhesions can prevent implantation. Hysteroscopy is one of the earliest approaches to direct study of the uterine cavity in case of repeat abortions, infertility and especially in repeated IVF failures. Also There are many evidences for the benefit yielded by hysteroscopy in improving pregnancy rates in patients with repeated IVF failure, even in the case of morphologically normal endometrium . It has been shown by recant data that hysteroscopy in the cycle preceding a subsequent IVF attempt nearly doubles the pregnancy rate in patients with at least two failed IVF attempts compared with starting IVF immediately. Injury-induced inflammatory response facilitates the transition of a non-receptive uterus into a receptive uterus which may increase pregnancy rate in these cases. In conclusion it seems legitimate to perform hysteroscopy in women who have had IVF-ET failures .