Hysteroscopy prior to repeat embryo transfer may improve pregnancy outcomes for asymptomatic women with repeated implantation failure

AimThe aim of this study was to evaluate the efficacy of hysteroscopy (HS) in detecting intrauterine abnormalities prior to repeat embryo transfer and improving pregnancy outcomes in asymptomatic women with repeated implantation failure (RIF). Material and MethodsA prospective cohort study was conducted involving 672 asymptomatic RIF women from a Chinese university hospital. Pregnancy outcomes between the HS (subdivided into patients with and without intrauterine abnormalities) and non-HS groups were compared. ResultsThe incidence of intrauterine abnormalities in the HS group was 37.13%. The most common abnormalities included endometrial polyps or polypoid endometrium, endometrial hyperplasia and intrauterine adhesions. Clinical pregnancy and implantation rates in the HS group were significantly higher than in the non-HS group (41.92% vs 32.25%; 23.82% vs 18.60%, respectively). There were no significant differences in early abortion, ectopic pregnancy, late abortion and live birth rates. The clinical pregnancy and implantation rates in both HS subgroups were significantly higher when compared to the non-HS group, whereas there were no significant differences between the subgroups. ConclusionHS improved pregnancy outcomes in women with or without intrauterine abnormalities. HS may be routinely performed before repeat embryo transfer in RIF women.