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Hysteroscopy after repeated implantation failure of assisted reproductive technology: A meta‐analysis.
- Source :
- Journal of Obstetrics & Gynaecology Research; Mar2018, Vol. 44 Issue 3, p365-373, 9p, 1 Diagram, 5 Charts, 2 Graphs
- Publication Year :
- 2018
-
Abstract
- Abstract: We conducted this meta‐analysis to explore the prognostic value of outpatient (or office) hysteroscopy (OH) preceding <italic>in vitro</italic> fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycles in women who had experienced repeated implantation failure (RIF), particularly in regard to the conflicting evidence reported by previous studies. Two reviewers independently searched Pubmed, MEDLINE, Web of Science, Cochrane Library and Embase to identify all publications of clinical trials of hysteroscopy with or without endometrial biopsy in RIF patients. The primary outcome measures were clinical pregnancy rate (CPR) and live birth rate (LBR). Pooled relative ratios (RRs) with 95% confidence intervals (CIs) were calculated. Publication bias was detected using funnel plots and Egger's regression tests. Six eligible studies comprising 4143 patients were included. The CPR and LBR were both significantly higher in RIF patients with OH than RIF patients without OH (CPR: RR 1.34, 95% CI 1.14–1.57, <italic>P</italic> < 0.05; LBR: RR 1.29, 95% CI 1.03–1.62, <italic>P</italic> < 0.05). Subgroup analysis revealed a significant association between OH and CPR in Asia (CPR: RR 1.49, 95% CI 1.31–1.69; <italic>P</italic> < 0.05) rather than in Europe (CPR: RR 1.08, 95% CI 0.93–1.26; <italic>P</italic> = 0.291). However, there was no evidence of a significant difference in either CPR or LBR between the normal and abnormal OH groups (CPR: RR 0.92, 95% CI 0.83–1.02, <italic>P</italic> = 0.12; LBR: RR 0.76, 95% CI 0.37–1.56, <italic>P</italic> = 0.450). Hysteroscopy may potentially improve pregnancy outcomes in patients with RIP. [ABSTRACT FROM AUTHOR]
- Subjects :
- BIRTH rate
CONFIDENCE intervals
EMBRYO transfer
FERTILIZATION in vitro
HYSTEROSCOPY
INFORMATION storage & retrieval systems
MEDICAL databases
MEDICAL information storage & retrieval systems
EVALUATION of medical care
MEDLINE
META-analysis
ONLINE information services
POPULATION geography
PREGNANCY
REGRESSION analysis
SYSTEMATIC reviews
TREATMENT effectiveness
ODDS ratio
Subjects
Details
- Language :
- English
- ISSN :
- 13418076
- Volume :
- 44
- Issue :
- 3
- Database :
- Complementary Index
- Journal :
- Journal of Obstetrics & Gynaecology Research
- Publication Type :
- Academic Journal
- Accession number :
- 128361828
- Full Text :
- https://doi.org/10.1111/jog.13571