Title: Thin Endometrium in IVF: Never Underestimate the Role of Hysteroscopy
Abstract: Background: A thin endometrium and other complicating factors in a patient's medical history may affect the outcome of in-vitro fertilization (IVF). Hysteroscopy and other tests can guide appropriate treatment for these factors and help improve the outcome of IVF in such patients. Case: A woman underwent a diagnostic hysteroscopy after an unsuccessful in-vitro fertilization (IVF) attempt at another center. This patient had an embryo transfer despite the fact that she had a reduced endometrial thickness of 4 mm. She had undergone an ovulation-induction treatment cycle with clomiphene citrate 1 month prior to the abovementioned IVF cycle. She also had a history of a dilatation and curettage for the removal of a polyp of the cervical canal. Results: Hysteroscopy showed endometrial and cervical-canal adhesions as well as an ∼3-mm-size endometrial polyp. The adhesions were treated with hysteroscopic scissors and the polyp was removed. Pathologic examination showed that that the latter diagnosis regarding the polyp was correct. This patient refused further postoperative treatments—such as oral contraceptive pills or an intrauterine device—despite the current authors' suggestion to do so. She refused this treatment, because she wanted to have a new IVF treatment cycle as soon as possible. Conclusions: This case reports highlights the need for hysteroscopic intervention in cases of thin endometrium found during IVF, especially when there is a relevant past clinical history. It also highlights the need for additional investigations in patients with failed IVF cycles as there may be other complicating factors involved. (J GYNECOL SURG 30:251)
Publication Year: 2014
Publication Date: 2014-07-21
Language: en
Type: article
Indexed In: ['crossref']
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