الفهرس 
Role of Uterine Cavity Abnormalities in Implantation Failure after ICSIOnly 14 pages are availabe for public view
 |  | from | 114 |  |  |
| | | from | 114 | | |
Abstract
Background: Despite the numerous advances in the field of in vitro fertilization (IVF) and intra-cytoplasmic sperm injection (ICSI), the implantation rate per embryo transferred usually does not exceed 30%, although higher rates with the use of blastocysts have been reported, depending on female age. Embryo quality, good conditions of the uterine environment, a skillful IVF laboratory and embryo transfer are essential in order to achieve a pregnancy in IVF.
Aim of the Work: The aim of the present study was to evaluate the sensitivity, specificity, positive and negative predictive values of a 3D vaginal ultrasound, to compare between 3D vaginal US and hysteroscopy which is the gold standard tool in the evaluation of the uterine cavity prior to ICSI.
Patients and Methods: This was a cross-sectional study, was conducted at the Department of Obstetrics and Gynaecology in Ain Shams University Hospital on 70 infertile female in child bearing period, were undergoing ICSI for the first cycle during a period of Six months from January 2022.
Results: Age (/years) <30 (40, 57.1%), ≥30 (30, 42.9%). Min. – Max, (22.0 – 35.0), Mean ± SD (28.20 ± 4.41), Median (IQR) 29.0 (24.0 – 32.0). History of repeated abortions with No (49, 70.0%) and YES (21, 30.0%). Type of infertility Primary (49, 70.0%), Secondary (21, 30.0%). Years of infertility with Min. – Max (2.0 – 7.0), Mean ± SD (3.93 ± 1.34) and Median (IQR)4.0 (3.0 – 5.0). Smoking with Non-smoker (52, 74.3%), Passive smoker (18, 25.7%). Regarding Hirsutism with No (46, 65.7%) and yes (24, 34.3%). RegardingAcne with No (34, 48.6%) and yes(36, 51.4%). Regarding BMI (kg/m2) with Min. – Max (23.20 – 32.0), Mean ± SD (27.41 ± 2.47) and Median (IQR) 27.55 (25.50 – 29.0). Regarding Lower limb edema with NO (57, 81.4%) and YES (13, 18.6%). There was no statistically significant difference regarding Outcome diagnosis (Normal, Endometrial polyp, Subseptate uterus, Arcuate uterus, Submucous fibroid, Intramural fibroid, Intrauterine adhesions, Cervical stenosis). According to the outcome in 3D vaginal US and Hysteroscopy (n = 70), (47Normal, 3Endometrial polyp, 4Subseptate uterus, 2Arcuate uterus, 4Submucous fibroid, 2Intramural fibroid, 2 Intrauterine adhesions, 1Cervical stenosis). Regarding 3D US, Hysteroscopy showing (sensitivity 86.96%, specificity 100.0 %, and accuracy 95.71%).
Conclusion: Three-dimensional transvaginal ultrasound can be used in diagnosing uterine focal lesions with results comparable to hysteroscopy. In addition, three-dimensional transvaginal ultrasound is relatively inexpensive, is not time consuming, and it is an office procedure. 3D sonography has a high level of accuracy for most uterine anomalies.