Lena TÜREYİCİ, Bekir KAHVECİ, İbrahim Ferhat ÜRÜNSAK

IVF-ICSI/ET başarısızlığı olan infertil hastalarda histeroskopi bulgularının değerlendirilmesi

fertilizasyon-intrastoplazmik sperm injeksiyonu/embriyo transferi) yapılmış ve başarısız olunmuş hastalarda histeroskopi ile intrauterin patolojileri saptamak ve bu patolojileri sınıflandırıp değerlendirilmesidir. Gereç ve Yöntem: Bu retrospektif çalışma 2013-2019 yılları arasında Çukurova Üniversitesi Tıp Fakültesi Balcalı Hastanesi Üreme Endokrinolojisi ve İnfertilite Bölümü’nde yapılmıştır. Bu çalışmaya, infertilite polikliniği’ne başvuran primer veya sekonder infertilite tanılı, daha önceden IVF-ICSI/ET yapılıp başarısızlıkla sonuçlanan ve bu nedenle histeroskopi uygulanan hastalar dahil edilmiştir. Bulgular: Çalışmaya alınan 228 hastanın histeroskopi sonuçları değerlendirildi. Bunlardan, %42,5’i (n=97) normal histeroskopik bulgulara, %57,5’i (n=131) anormal histeroskopik bulgulara sahipti. Bu anormal bulgular incelendiğinde, en sık izlenen patoloji endometrial polip %23,1 (n=36) idi. Diğer bulgular; intrauterin sineşi %20,5 (n=32), servikal patoloji %18,6 (n=29), servikal stenoz %13,5 (n=21), uterin subseptum %10,9 (n=17), myoma uteri %4,5 (n=7), arkuat uterus %3,2 (n=5), T-shape uterus %3,2 (n=5), intrauterin enfeksiyon %1,9 (n=3) ve vajinal septum %0,6 (n=1) idi. Sonuç: İmplantasyon başarısızlığı olan hastalarda nedene yönelik ek incelemeler yapılmalıdır. Histeroskopinin IVF üzerine olan pozitif etkisi endometrial kavitedeki lezyonları saptama ve tedavi etmesi ile ilişkilidir. Ayrıca histeroskopi, diğer araştırma yöntemleri tarafından gözden kaçırılan intrauterin patolojileri saptayabilir. Böylece IVF başarısızlığı olan hastaların yönetimine olumlu katkı sağlayabilir.

Anahtar Kelimeler:

İnfertilite, IVF-ICSI/ET, histereskopi, intrauterin patoloji

Evaluation of hysteroscopy findings in infertility patients with IVF-ICSI / ET failure

Purpose: The aim of this study was to determine intrauterine pathologies by hysteroscopy in patients who have undergone IVF-ICSI/ET (in vitro fertilization intracytoplasmic sperm injection / embryo transfer) and have failed, and to classify and evaluate these pathologies. Materials and Methods: This retrospective study was conducted between 2013 and 2019 at the Reproductive Endocrinology and Infertility Department of Çukurova University Faculty of Medicine, Balcalı Hospital. In this study, patients with primary or secondary infertility diagnosis who applied to the infertility outpatient clinic, who had previously undergone IVF-ICSI / ET and failed and therefore underwent hysteroscopy were included. Results: The hysteroscopy results of 228 patients included in the study were evaluated. Of these, 42.5% (n = 97) had normal hysteroscopic findings, 57.5% (n = 131) had abnormal hysteroscopic findings. When these abnormal findings were examined, the most common pathology was endometrial polyp 23.1% (n=36). Other findings were; intrauterine synechiae 20.5% (n =32), cervical pathology 18.6% (n =29), cervical stenosis 13.5% (n =21), uterine subseptum 10.9% (n =17), myoma uteri 4.5% (n =7), arcuate uterus 3.2% (n =5), T-shaped uterus 3.2% (n =5), intrauterine infection 1.9% (n =3), and vaginal septum 0.6% (n =1). Conclusion: Additional investigations for the cause should be performed in patients with implantation failure. The positive effect of hysteroscopy on IVF is related to its detection and treatment of lesions in the endometrial cavity. In addition, hysteroscopy can detect intrauterine pathologies missed by other research methods. Thus, it can contribute positively to the management of patients with IVF failure.

Keywords:

Infertility, IVF-ICSI/ET, hysteroscopy, intrauterine pathology,

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