THE ROLE OF DIAGNOSTIC HYSTEROSCOPY AND ENDOMETRIAL BIOPSY IN ASSISTED REPRODUCTIVE TECHNOLOGIES

Objective: To study the incidence of unsuspected endouterine abnormali ties in patients for whom NF-ET repeatedly fails. Design: Prospective study. Setting: Infertility Unit of the Department of Obstetrics and G ynecology, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy. Patien t(s): One hundred patients for whom two IVF-ET cycles failed in which greater than or equal to 2 good-quality embryos were transferred. Inte rvention(s): In-office diagnostic hysteroscopy and endometrial biopsy. Main Outcome Measure(s): Relation between NF-ET failure and unsuspect ed endouterine abnormalities. Result(s): In 18 patients, hysteroscopy showed an important unsuspected endouterine abnormality. Fifteen of th ese patients did not become pregnant after IVF-ET, and 3 became pregna nt but had a spontaneous abortion. Histologic examination of the endom etrium revealed chronic endometritis in 1 patient and tuberculous endo metritis in another. Conclusion(s): Previous studies have reported tha t the incidence of endouterine abnormalities is high in patients under going IVF-ET. Our data confirm the previous reports and lead us to con clude that diagnostic hysteroscopy should be performed on all patients before they undergo IVF-ET. (Fertil Steril(C) 1998;70:378-80. (C) 199 8 by American Society for Reproductive Medicine.).