Hysteroscopic evaluation of endocervical and endometrial lesions observed after different procedures of embryo transfer: A prospective comparative study
Received 16 January 2009; received in revised form 23 July 2009; accepted 18 August 2009. published online 03 September 2009.
Abstract
Objective
Endocervical and endometrial damage observed after different procedures of embryo transfer (ET) were investigated using diagnostic hysteroscopy.
Study design
Prospective, descriptive and comparative study, in an Infertility centre, University Hospital. Hundred consecutive infertile patients with a normal uterine cavity, included in an IVF program, were enrolled between May 1st, 2006 and April 30th, 2007. All the patients had a diagnostic hysteroscopy immediately after trial ET using soft ET catheters: (i) IVF Sydney Set (Cook, Limerick, Ireland) (n=27), (ii) Elliocath (Ellios, Paris, France) (n=34), (iii) Frydman classic 4.5 (CCD, Paris, France) (n=19), and rigid ET catheters: Memory Frydman 4.5 (CCD, Paris, France) (n=20). All the procedures were recorded and blindly reviewed. Data were analyzed using a Kruskal-Wallis test for age and severity of endometrial lesions, or Fisher's exact test for binary criteria.
Results
Endocervical lesions were more frequently encountered in the soft (63%) and rigid (85%) Frydman's catheter groups compared to other groups (Elliocath: 29%, IVF Sydney Set: 26%; p<0.0001). Presence of blood on the catheter, and endometrial lesions were significantly less frequent in soft catheter groups compared to the rigid catheter group (p<0.0001). Severe endometrial lesions were less frequently observed when soft catheters were used (85%, 53%, 32%, 11% for Memory Frydman, Frydman classic, Elliocath and IVF Sydney Set, respectively; p<0.0001). The presence of blood on the catheter signed severe endometrial lesions.
Conclusion
All ET catheters can lead to endocervical and endometrial damage. Severe endometrial lesions were less frequent when soft catheters were used.
aDepartment of Obstetrics and Gynecology, CHU Jean Verdier, AP-HP, Bondy, France
bUFR SMBH Leonard de Vinci, Université Paris 13, Bobigny, France
cDepartment of Reproductive Biology, CHU Jean Verdier, AP-HP, Bondy, France
dDepartment of Biostatistics, CHU Saint-Louis, AP-HP, Paris, France
Corresponding author at: Pôle Femme et Enfant, Department of Obstetrics and Gynecology, CHU Jean Verdier, Assistance Publique-Hôpitaux de Paris, Avenue du 14 Juillet, 93140 Bondy, France. Tel.: +33 148026856; fax: +33 148026860.
ABSTRACT