Effectiveness of Laparoscopy and Hysteroscopy to Optimize the Outcome of Assisted Reproductive Technology

Abstract

Background: Identifying the cause of infertility is complex and often reveals overlapping etiologies. Because of the valuable characteristics of hysteroscopy, it has been deemed a promising surgical intervention to improve in vitro fertilization (IVF) outcomes. The present study aimed to evaluate the role and effectiveness of combined laparoscopy and hysteroscopy in the assessment of uterine pathologies in infertile women with recurrent implantation failure (RIF) after IVF, and explore whether removal of such pathologies increased the rate of pregnancy in those women. Methods: This prospective observational cohort study included 40 infertile patients presented with either primary or secondary infertility after repeated IVF/ intracytoplasmic sperm injection (ICSI) failure. Participants were selected from Endoscopy and Assisted Reproductive units in Obstetrics and Gynecology department at Tanta University Hospital. Results: There was a statistically significant higher rate of successful cases in the abnormal hysteroscopic findings group. There was no statistically significant difference between normal and abnormal laparoscopic findings groups as regard successful ICSI procedure. Conclusions: Hysteroscopy is recommended to be a routine diagnostic and therapeutic tool in any case with RIF or recurrent IVF/ICSI failures before a new attempt as it increases the success rate. We can’t recommend routine laparoscopy in any case with RIF or recurrent IVF/ICSI failures.