Abstract
Purpose
To assess the efficacy of chromohysteroscopy in detecting endometrial pathologies in recurrent in vitro fertilization (IVF) failure.
Materials and methods
Sixty-four patients in whom conventional hysteroscopy did not show any apparent endometrial pathology were included. Five milliliter of 1% methylene blue dye was introduced through the hysteroscopic inlet. Biopsies were obtained both from dark stained and light stained areas.
Results
The study group was grouped according to the staining characteristics. Group I included 22 patients in whom focal dark staining was observed. Group II included 41 patients in whom diffuse light blue staining without dark areas was observed. There was no significant difference between two groups in age, smoking, body mass index, number of IVF failure and time to hysteroscopy after the last failure. But, there was a statistically significant difference in the incidence of endometritis between two groups (p = 0.007). The power of dark staining for detection of endometritis was calculated as follows: sensitivity 69.2%, specificity 74%, positive predictive value 40.9% and negative predictive value 90.2%.
Conclusion
Chromohysteroscopy improves the efficacy of hysteroscopy in recurrent IVF failure. Observation of diffuse light blue staining without dark areas strongly suggests a normal endometrium free of endometritis.
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References
Rowe PJ, Comhaire FH, Hargreave TB, Mellows HJ. WHO manual for the standardized investigation and diagnosis of the infertile couple. Cambridge: The Press Syndicate of the University of Cambridge; 1993.
Sano Y, Muto M, Tajiri H, Ohtsu A, Yoshida S. Optical/digital chromoendoscopy during colonoscopy using narrow-band imaging system. Dig Endosc. 2005;17:S43–8.
DaCosta RS, Wilson BC, Marcon NE. Photodiagnostic techniques for the endoscopic detection of premalignant gastrointestinal lesions. Dig Endosc. 2003;15:153–73.
Bettochi S, Selvaggi L. A vaginoscopic approach to reduce the pain of office hysteroscopy. J Am Assoc Gynecol Laparosc. 1997;4:255–8.
Kirsop R, Porter R, Torode H, Smith D, Saunders D. The role of hysteroscopy in patients having failed IVF/GIFT transfer cycles. Aust N Z J Obstet Gynaecol 1991;31:2263–4.
Demirol A, Gürgan T. Effect of treatment of intrauterine pathologies with office hysteroscopy in patients with recurrent IVF failure. RBM Online 2004;8:590–4.
Oliveira FG, Abdelmassih VG, Diamond MP, Dozortsev D, Nagy ZP, Abdelmassih R. Uterine cavity findings and hysteroscopic interventions in patients undergoing in vitro fertilization–embryo transfer who repeatedly cannot conceive. Fertil Steril 2003;80:1371–5.
La Sala GB, Montanari R, Dessanti L, Cigarini C, Sartori F. The role of diagnostic hysteroscopy and endometrial biopsy in assisted reproductive technologies. Fertil Steril 1998;70:378–80.
Zeyneloglu HB, Onalan G, Dursun P, Altuntas B. Polypoid appearance of the endometrium on office hysteroscopy a significant predictor of miscarriage after IVF–ET. Fertil Steril 2007;88:S96.
Cicinelli E, Resta L, Nicoletti R, Zappimbulso V, Tartagni M, Saliani N. Endometrial micropolyps at fluid hysteroscopy suggest the existence of chronic endometritis. Hum Reprod 2005;20:1386–9.
Marconi G, Vilela M, Quintana R, Diradourian M, Young E, Sueldo C. New observations on endometrial physiology after transcervical injection of methylene blue dye. Fertil Steril. 2004;82:1700–4.
Fedele L, Bianchi S, Marchini M, Franchi D, Tozzi L, Dorta M. Ultrastructural aspects of endometrium in infertile women with septate uterus. Fertil Steril. 1996;65:750–2.
Li TC, Makris M, Tomsu M, Tuckerman E, Laird S. Recurrent miscarriage: aetiology, management and prognosis. Hum Reprod. 2002;8:463–81.
Bajekal N, Li TC. Fibroids, infertility and pregnancy wastage. Hum Reprod Update. 2000;6:614–20.
Barash A, Dekel N, Fieldust S, Segal I, Schechtman E, Granot I. Local injury to the endometrium doubles the incidence of successful pregnancies in patients undergoing in vitro fertilization. Fertil Steril. 2003;79:1317–22.
Margolioth EJ, Ben-Chetrit A, Gal M, Eldar-Geva T. Investigation and treatment of repeated implantation failure following IVF–ET. Hum Reprod. 2006;21:3036–43.
Burton G, Abdalla HI, Kirkland A, Studd JWW. The role of oocyte donation in women who are unsuccessful with in-vitro fertilization treatment. Hum Reprod. 1992;7:1103–5.
Budak E, Garrido N, Soares SR, Melo MAB, Meseguer M, Pellicer A, Remohi J. Improvements achieved in an oocyte donation program over a 10-year period: sequential increase in implantation and pregnancy rates and decrease in high-order multiple pregnancies. Fertil Steril 2007;88(2):342–9. DOI 10.1016.
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Capsule Chromohysteroscopy improves the efficacy of hysteroscopy in recurrent IVF failure.
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Küçük, T., Safali, M. “Chromohysteroscopy” for evaluation of endometrium in recurrent in vitro fertilization failure. J Assist Reprod Genet 25, 79–82 (2008). https://doi.org/10.1007/s10815-007-9196-8
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DOI: https://doi.org/10.1007/s10815-007-9196-8