The inSIGHT study: costs and effects of routine hysteroscopy prior to a first IVF treatment cycle. A randomised controlled trial

JG Smit, JC Kasius, Rene Eijkemans, CAM Koks, R Van Golde, JGE Oosterhuis, AW Nap, GJ Scheffer, PAP Manger, A Hoek, M (Mesrure) Kaplan, DBC Schoot, AM Heusden, WKH Kuchenbecker, DAM Perquin, Kathrin Fleischer, EM Kaaijk, A Sluijmer, J Friederich, Joop LavenM van Hooff, LA Louwe, J Kwee, JJ Boomgaard, CH de Koning, ICAH Janssen, F (Femke) Mol, BWJ (Ben) Mol, HL Torrance, FJM Broekmans

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Abstract

Background: In in vitro fertilization (IVF) and intracytoplasmatic sperm injection (ICSI) treatment a large drop is present between embryo transfer and occurrence of pregnancy. The implantation rate per embryo transferred is only 30%. Studies have shown that minor intrauterine abnormalities can be found in 11-45% of infertile women with a normal transvaginal sonography or hysterosalpingography. Two randomised controlled trials have indicated that detection and treatment of these abnormalities by office hysteroscopy after two failed IVF cycles leads to a 9-13% increase in pregnancy rate. Therefore, screening of all infertile women for intracavitary pathology prior to the start of IVF/ICSI is increasingly advocated. In absence of a scientific basis for such a policy, this study will assess the effects and costs of screening for and treatment of unsuspected intrauterine abnormalities by routine office hysteroscopy, with or without saline infusion sonography (SIS), prior to a first IVF/ICSI cycle. Methods/design: Multicenter randomised controlled trial in asymptomatic subfertile women, indicated for a first IVF/ICSI treatment cycle, with normal findings at transvaginal sonography. Women with recurrent miscarriages, prior hysteroscopy treatment and intermenstrual blood loss will not be included. Participants will be randomised for a routine fertility work-up with additional (SIS and) hysteroscopy with on-the-spot-treatment of predefined intrauterine abnormalities versus the regular fertili Discussion: The results of this study will help to clarify the significance of hysteroscopy prior to IVF treatment.
Original languageUndefined/Unknown
JournalBMC Womens Health
Volume12
DOIs
Publication statusPublished - 2012

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