Uterine Lesions and Their Association to Invitro Fertilization(IVF) or Intracytoplasmic Sperm Injection(ICSI) Outcome

Study Overview
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Brief Summary
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To study the effect of uterine wall , intracavitary , cervical as well as cervical canal lesion on the outcome of IVF/ICSI cycle. To establish a score for prediction of IVF/ICSI cycle success .

Detailed Description
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IVF is one of the most successful treatment of fertility, (1) however, several IVF cycles fail to achieve pregnancy (2).failure defined as three or more failed attempts of ICSI (3). Implantation failure is a complex in nature, may be due to structural or functional causes (3, 4). that previously undiagnosed, misinterpreted initial diagnoses, or subtle newly added intrauterine abnormalities may be a significant cause of IVF failure (5, 6), studies say that intra-uterine pathologies represent 40-50 % of causes of ICSI failure (7, 8), hysteroscopic removal of endometrial polyps, submucous fibroids, uterine septum, or intrauterine adhesions could increase the pregnancy rate (9). so, Evaluation of the uterine cavity may become a routine investigation before assisted reproductive technology(ART) procedures (10). In this study, we evaluate the relationship between the different uterine and cervical pathologies and decreased live birth rate.

Official Title
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Association Between Uterine , Intracavitary , Cervical and Cervical Canal Lesions With in Vitro Fertilization/Intracytoplasmic Sperm Injection(IVF/ICSI) Outcome.

Conditions
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IVF

Intervention / Treatment
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* Procedure: IVF


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Women between 18 and 38 years old. An indication for IVF/ICSI.. Women with BMI between 18.5 : 29.9 . Women with normal antimullerian hormone(AMH), antral follicle count(AFC) (good responders). Exclusion Criteria: Refusal to join the study. Women with age less than 18 and more than 38 . Women with BMI less than 18.5 and more than 30 . Untreated tubal hydrosalpinges. Poor responders as assessed by AFC 4 or less ,AMH O.8 ng/dl (nice 2013).

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 38 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group A<br>Women with hysteroscopically or ultrasonographic detected uterine anomalies(adenomyosis,fibroid) intracavitary lesions ( like polyp, adhesion or septum) and those with detected endometrial abnormalities (like hypervascularization,pale endometrium) ,cervical lesion and cervical canal lesion or pelvic lesion | Procedure: IVF<br>* In vitro fertilization<br>|
| Group B<br>Matched women (eg. Age,parity, BMI, ovarian reserve….) with no uterine or ovarian abnormalities assessed by hysteroscopy or ultrasonography. | Procedure: IVF<br>* In vitro fertilization<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pregnancy rate | Pregnancy rate with IVF/ICSI with uterine lesions | Baseline |