The expediency of mandatory combined endoscopy in increasing of assited reproductive technology efficiency

Е. А. Маркова, Т. A. Kuznetsova, V. V. Vostricov, S. V. Salfetkina
In: Journal of obstetrics and women's diseases · 2005 · vol. 54(5S) , pp. 27 · doi:10.17816/jowd87199 · W3214456080
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This study evaluated 168 IVF patients, finding that mandatory combined endoscopy detected significant uterine and tubal pathologies including endometriosis, confirming the approach's expediency for preparing patients for assisted reproductive technology programs.

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This review evaluated 168 patients undergoing in vitro fertilization to assess the impact of mandatory combined endoscopic examination prior to treatment. The study found that hysteroscopy identified endometrial pathology in 65 percent of cases, while laparoscopy detected hydrosalpinx in 20 percent and external genital endometriosis in 12.5 percent. Although pregnancy rates were slightly higher in the group receiving pre-IVF endoscopic correction (37.5 percent) compared to those without it, the authors concluded that identifying and treating these pathologies is essential for optimizing assisted reproductive technology outcomes. Relevance to endometriosis: The paper cites endometriosis as a specific finding in 12.5 percent of IVF candidates diagnosed via laparoscopy, supporting its use in evaluating infertility causes.

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Abstract

Introduction. Evaluation of 168 patients participating in IVF programs was performed depending on the results of combined endoscopic examination and subsequent treatment. The pathology of endometrium was detected in more than half of the cases, while hydrosalpinx was revealed in 20% of the patients, and every tenth patient suffered from endometriosis. The expediency of the approach under the study for preparing the patients for IVF programs has been confirmed. The present study was aimed an evaluation of expediency and efficacy of combined endoscopic examination in preparing for subsequent participation of female patients in IVF programs.
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Abstract

Introduction. Evaluation of 168 patients participating in IVF programs was performed depending on the results of combined endoscopic examination and subsequent treatment. The pathology of endometrium was detected in more than half of the cases, while hydrosalpinx was revealed in 20% of the patients, and every tenth patient suffered from endometriosis. The expediency of the approach under the study for preparing the patients for IVF programs has been confirmed. The present study was aimed an evaluation of expediency and efficacy of combined endoscopic examination in preparing for subsequent participation of female patients in IVF programs. Full Text Introduction. Evaluation of 168 patients participating in IVF programs was performed depending on the results of combined endoscopic examination and subsequent treatment. The pathology of endometrium was detected in more than half of the cases, while hydrosalpinx was revealed in 20% of the patients, and every tenth patient suffered from endometriosis. The expediency of the approach under the study for preparing the patients for IVF programs has been confirmed. The present study was aimed an evaluation of expediency and efficacy of combined endoscopic examination in preparing for subsequent participation of female patients in IVF programs.

Material

and methods. The study involved 168 patients participating in IVF programs in accordance with a standard long-term protocol of ovulation induction from 21st day of 28 days cycle. Depending on ovulation time, volume of preliminary research and correction of detected pathology, the patient population was divided in three groups. Group I consisted of 40 (23,8%) patients, who had undergone a combined endoscopic examination prior to a subsequent IVF cycle. Group II comprised 61 (41,0%) patient with a history of various kinds of endoscopic and surgical treatment directed at correction of the reproductive function. 59 patients from Group III did not have an endoscopic examination. Results. Besides previous faulty attempts at administering IVF, the indication for performing a combined endoscopic examination (including hysteroscopy and manipulatory laparoscopy) were clinical and ultrasound sings of pathology in endometrium, a suspicion for the presence of hydrosalpinx or genital endometriosis. During endoscopy, hysteroscopy revealed pathology of endometrium in more than half of the patients (65%), hydrosalpinx - in 20% of cases, and external genital endometriosis in every tenth patient (12,5% of cases). Corrected therapy was given and pregravidary preparatory measures were taken considering the revealed pathology. As a result of subsequent IVF procedures, gestation occurred in 37,5%, 30,4% and 30,5% of the patients from Group I, II and III, respectively. Conclusions. Thus, combined endoscopic examination and subsequent correction of pathology are the mandatory stages in preparing of female patients for participation in the IVF programs in the event of preceding gestational failures and revealing of clinical and paraclinical evidences of gynecological pathology. Implementation of this particular approach promotes for an increase in efficacy of infertility overcoming through administration of supplementary reproductive technologies (IVF). About the authors Е. А. Markova Altai State Medical University; Siberian Institute of Human Reproduction and Genetics Email: [email protected] No. 1 Department of Obstetrics and Gynecology Russian Federation, Barnaul; BarnaulТ. A. Kuznetsova Altai State Medical University; Siberian Institute of Human Reproduction and Genetics Email: [email protected] Siberian Institute of Human Reproduction and Genetics Russian Federation, Barnaul; BarnaulV. V. Vostricov Altai State Medical University; Siberian Institute of Human Reproduction and Genetics Email: [email protected] No. 1 Department of Obstetrics and Gynecology Russian Federation, Barnaul; BarnaulS. V. Salfetkina Altai State Medical University; Siberian Institute of Human Reproduction and Genetics Author for correspondence. Email: [email protected] No. 1 Department of Obstetrics and Gynecology Russian Federation, Barnaul; Barnaul

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