Effects of hysteroscopic assisted diagnostic endometrial curettage in controlled ovarian hyperstimulation cycles

Authors: X. Huang, Y.  Shanghai/CN

1. Purpose
       To evaluate the effects of hysteroscopic assisted diagnostic endometrial curettage in patients with abnormal endometrial echoes by transvaginal sonography and to identify its vaule and clinic outcome in the following controlled ovarian hyperstimulation cycles. 上海中医药大学附属曙光医院东院生殖医学中心黄晓燕
2. Methods and Materials
       Eighty patients with an abnormal endometrial echoes and 58 cases with normal endometrial echoes by
transvaginal sonography in follicular phase in natural cycle before the IVF-ET cycle were divided into three
groups; 40 patients with an abnormal endometrial echoes underwent hysteroscopic assisted diagnostic
endometrial curettage as HADC group, half of another 40 patients underwent diagnostic endometrial curettage
only as DC group. IVF-ET cycle was performed in the following menstrual cycle. 58 cases with normal
endometrial echoes had not undergone any surgery as control group. The pattern of endometrial echoes by
transvaginal sonography was compared before and after surgery in the different cycles in HADC group and in
DC group, the clinical characters and outcomes were also compared among three groups. Statistical analysis
was performed using T and 2 test at 0.05 significance level for comparisons between groups.
3. Results
       There was no significant difference in mean age, baseline FSH, peak E2, oocyte retrieved, embryos transferred, and the thickness of endometrium between three groups. In HADC group and in DC group, the ratio of type A endometrial echoes was significantly increased in the following controlled ovarian hyperstimulation cycles (70.0% vs 63.3%) than in previous nature cycles (16.0% vs 20.0%), and the ratio of type B, type C echoes was significantly decreased (P<0.05). But compared with control group, the ratio of type A endometrial echoes was significantly lower both in HADC group and in DC group, and the ratio of type B, type C echoes was significantly higher (P<0.05). The clinic pregnancy rate in HADC group (57.5%) was statistically higher than that of in DC group (42.5%) and in control group (43.1%)(P<0.05). There was no significance difference between DC group and control group (P>0.05).
4. Conclusion
     It is conceivable that hysteroscopic assisted diagnostic endometrial curettage as an effective strategy more likely altered endometrial environment can improve intrauterine disorder and the capacity of reproduction. Patients with an abnormal endometrial echoes by transvaginal sonography underwent diagnostic endometrial curettage, hysteroscopic assisted diagnostic endometrial curettage especially, are highly valuable and significantly increase the clinic pregnancy rate in the following treatment.