الفهرس 
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Abstract
Implantation failure could be due to a variety of reasons, including
embryo quality and uterine receptivity, but remains unexplained in many
cases.
It represents a major cause of stress to both the clinician and the
patient undergoing intracytoplasmic sperm injection (ICSI) cycle. Even
minor uterine cavity abnormalities, such as endometrial polyps, small
submucous myomas, adhesions, and septa are considered to have a negative
impact on the chance to conceive. The presence of uterine pathology may
negatively affect the chance of implantation. The prevalence of unsuspected
uterine pathology in asymptomatic women with implantation failure has been
reported to be as high as 50%.
The high prevalence of intrauterine pathologies in infertile women
makes evaluation of the uterine cavity for fibroids, polyps, adhesions, and
Mullerian abnormalities a reasonable decision. Therefore, one of the common
investigations proposed for women undergoing IVF treatment is to evaluate
the uterine cavity via hysteroscopy. Hysteroscopy is the gold standard test for
assessing the uterine cavity
It is generally performed as a definitive diagnostic tool to evaluate
abnormal findings on hysterosalpingogram or saline hysterosonography
performed during the course of investigation of subfertile women.
Hysteroscopy not only provides accurate visual assessment of the
uterine cavity, but also provides a chance to treat any pathology detected
during the examination. The availability of hysteroscopes with a smaller diameter has made the use of outpatient or office hysteroscopy feasible as a
routine examination.
Currently, there is evidence that performing hysteroscopy before
starting IVF treatment could increase the chance of pregnancy in the
subsequent IVF cycle in women who had one or more failed IVF cycles.
In the current study we aimed to evaluate role of Vaginal three
dimensional ultrasound, chromohysteroscopy for endometrial evaluation in
cases of previous failed intracytoplasmic sperm injection and
histopathological examination of the suspected areas.
This study was conducted on 50 cases with mean age of studied cases
was 29.1 years and mean BMI was 24.38.
In the current study we found that mean duration of infertility was
3.53 years and common cause was ovulatory problem in 36% of cases, male
factor in 30% of cases, tubal factor in 24% of cases, endometriosis in 36% of
cases and unexplained infertility in 4%.
In the current study we found that mean days of menstrual cycle were
6.38, mean number of failed cycles were 1.52 and mean number of embryos
transferred were 2.02.
In the current study we found that mean AMH level was 2.89, mean
FSH was 7.5, mean LH level was 5.8, mean TSH was 3.73 and mean PRL
was 15.12.
In the current study we found that 84% showed easy hysteroscopic
entry but in 16% had difficult entry.
In the current study we found that ultrasound had normal findings in
48% cases, and most common abnormality founded was Cs scar niche in 18% of cases followed by, arcuate uterus in 10% of cases, arcuate uterus + T
shaped cavity in 8 %, cervical echogenic mass q polyp, endometrial polyp,
polypoidal endometrium in 4% of cases, cervical polyp, false endometrial
polyp in 2%.