الفهرس 
Pregnancy rates and outcomes of IVF & ICSIOnly 14 pages are availabe for public view
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Abstract
This study was prospective clinical comparative cohort study, conducted at Obstetrics and Gynecology Department, Menofia University and a private Reproduction & IVF Unit, Cairo, Egypt.
The study was designed to evaluate the clinical efficacy of routine hysteroscopy (HC) in infertile women with no abnormality detected in TV/US examination, before starting primary ICSI cycle. Also to evaluate the effect of hysteroscopy (HC) and ICSI outcomes in women with history at least two previous failed ICSI attempts, (RIF).
Methodology: ICSI after hysteroscopy was performed in two groups of infertile women. Patients with normal uterine cavity (group I, no = 125 ) and patients with RIF ( group II, no = 125 ). Then, ICSI was performed for all subjects of the two study groups with no statistically significant difference (p > 0.05) regarding the number of oocytes retrieved and the number of embryo transfer. Then, all subjects were followed up for 3 weeks after embryo transfer for detection of pregnancy by ultrasound.
Results: There was statistically significant difference in IR both groups (15.8% Vs. 10.2%, p = 0.03). Also, the PR showed no statistically significant difference (32% vs. 22.4%, p = 0.089). There is a statistically significant association between the use of hysteroscopy prior to ICSI in group II. In addition, hysteroscopy had detected abnormalities in near half of cases whose ultrasound was normal.
Conclusions: Routine office hysteroscopy appears to be an essential step and not an add cost for infertility workup before ICSI even in patients with normal TV/US. Robust and high-quality RCTs are still needed before hysteroscopy can be regarded as a first-line procedure in all infertile women, especially during the basal clinical assessment of the couple. Recommendations This study supports the importance of the correction of any significant uterine cavity lesion to have a successful IVF/ICSI cycle with outcomes comparative to patients with normal uterine cavity. Intervention to correct any subtle endometrial abnormalities is not needed as this does not add to the success rate of IVF/ICSI cycle. Robust and high-quality RCTs are still needed before hysteroscopy can be regarded as a first-line procedure in all infertile women, especially during the basal clinical assessment of the couple, when assisted reproductive treatment is not indicated yet.