İn Vitro Fertilizasyon Öncesi Ofis Histeroskopi Bulgularının Değerlendirilmesi
Özet
Amaç: Çalışmada IVF öncesi ofis histeroskopi yapılan hastaların bulgularının değerlendirilerek servikal kanal ve uterin kavite patolojilerinin saptanması amaçlanmıştır.
Çalışmanın Yapıldığı Yer: Sağlık Bilimleri Üniversitesi Zübeyde Hanım Kadın Hastalıkları ve Doğum Hastanesi, IVF Kliniği
Yöntem ve Gereçler : Retrospektif olarak yapılan bu çalışmada 4 Ocak 2016 ve 31 Ocak 2018 tarihleri arasında T.C.S.B. Ankara Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi IVF Kliniği’ne başvuran 770 hastanın servikal kanal ve uterin kavite patolojileri değerlendirildi. Histeroskopik olarak patoloji saptanmayan hastalar Grup I(n:542), histeroskopide servikal kanal ve uterin kavitede patoloji saptanan hastalar Grup II(n:248) olarak kabul edildi.Her iki gruptaki hastaların implantasyon, klinik gebelik ve canlı doğum oranları karşılaştırıldı.
Bulgular: Gruplar arasında yaş, gebelik öyküsü, infertilite süresi, infertilite etiyolojisi, VKİ açısından istatistiksel olarak anlamlı fark saptanmadı. IVF öncesi histeroskopide servikal kanal ve uterin kavite patolojilerinin sıklığı %29.6 olarak saptandı. Grup I ve Grup II’de canlı doğum oranları sırasıyla %18 ve % 20.1 olarak bulundu. Her iki grup arasında, canlı doğum açısından istatistiksel bir fark saptanmadı (p>0.05).Grup II’de histeroskopik olarak tespit edilen patolojiler TVUSG bulguları ile karşılaştırıldığında patolojilerinin etyolojisine göre TVUSG duyarlılığının % 21.4 ile %100 arasında değişebileceği saptandı.
Sonuçlar: IVF öncesi histeroskopi yapılan hastalardaki patolojik bulguları ve bunların insidansını saptadık. IVF öncesi histeroskopik olarak saptanan patolojilere müdahale etmenin klinik gebelik ve canlı doğum oranlarını istatistiksel olarak arttırmadığını belirledik.
Purpose: In this research, it was aimed to determine the cervical canal and uterine cavity pathologies by evaluating the patients who underwent office hysteroscopy before IVF.
Setting: Ankara Etlik Zübeyde Hanım Gynecology and Obstetrics Research Hospital, Reproductive Endocrinology and Infertility Discipilne, Assisted Reproductive Treatments Center
Methods and Materials: In this retrospective study, cervical canal and uterine cavity pathologies of 770 patients who underwent office hysteroscopy between January 4, 2016 and January 31, 2018 were evaluated. Patients with no pathology in hysteroscopy were determined as Group I (n: 542), patients with uterine cavity and cervical canal pathology were determined as Group II (n: 248). Implantation, clinical pregnancy and live birth rates were compared in both groups.
Results: No statistically significant difference was found between the groups in terms of age, pregnancy history, infertility period, etiology of infertility and BMI. The frequency of cervical canal and uterine cavity pathology were found to be 29.6% in pre-IVF hysteroscopy. Live birth rates were 18% and 20.1% in Group I and Group II. Respectively there was no statistical difference between the two groups in terms of live birth (p> 0.05). In Group II, the pathologies detected in hysteroscopy were found to vary between 21.4% and 100% according to the etiology of cervical canal and uterine cavity pathology compared to TVUSG findings.
Conclusion: We determined the pathological findings and their incidence in patients undergoing hysteroscopy before IVF. We found that hysteroscopic intervention to pathologies before pre-IVF did not increase clinical pregnancy and live birth rates statistically.
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