The effect of diagnostic hysteroscopy performed before fresh and frozen-thawed embryo transfer in IVF cycles on reproductive outcomes

Abstract

Objective: Hysteroscopy is frequently performed in infertile women and thought to improve pregnancy rates. The data obtained from studies investigating the effect of hysteroscopy in in-vitro fertilization (IVF) cycles is variable. We aimed to evaluate the effect of hysteroscopy on pregnancy outcomes of fresh and frozen-thawed embryo transfers (FET) performed during IVF cycles. Material and Methods: The data of the 765 patients, who had IVF treatment between January 2015 and July 2017 in an infertility center, were retrospectively analyzed. Of those, 586 ( 76.6\%) patients underwent fresh embryo transfer, while 179 (23.4\%) patients underwent FET. Hysteroscopy performed by a single experienced surgeon was scheduled two months before transfer. Hysteroscopy was performed in 101/586 (17.2\%) in those undergoing fresh embryo transfer and 44/179 (24.6\%) patients in the FET group. Pregnancy outcomes of the groups were compared respectively within their own group. Results: The mean age was similar in patients in the fresh and FET groups (p=0.365, respectively). There was no difference in the number of transferred embryos between the groups ( p=0.218). In the fresh embryo group there were 246 pregnancies, of which 44 had undergone diagnostic hysteroscopy while 202 had not, (p=0.516) and 79 pregnancies in the FET group, of which 20 had undergone diagnostic hysteroscopy while 59 had not (p=0.711). There was no statistical difference according to pregnancy rate between the groups (p=0.538). Conclusion: Performing diagnostic hysteroscopy before fresh or FET does not improve the pregnancy rates.