Is it necessary to perform a routine hysteroscopy before first embryo transfer in patients with previous ectopic pregnancy history: A propensity score matching analysis?

Abstract

Purpose To determine whether an office hysteroscopy is required before the first embryo transfer in infertile women with previous ectopic pregnancy history. Methods Consecutive patients with previous ectopic pregnancy history were categorized into two groups based on the performance of hysteroscopy. Subgroup 1 consisted of patients whose endometrial pathology was normal, subgroup 2 who were diagnosed with endometrial polyps (EP), and subgroup 3 diagnosed with chronic endometritis (CE). Demographics, baselines of characteristics, and pregnancy outcomes after embryo transfer were compared among these groups. Results A total of 614 patients were enrolled. No differences were observed in the baseline characteristics of these groups. The clinical pregnancy rates were comparable between hysteroscopy group and non-hysteroscopy group. The spontaneous miscarriage rate was greater in the cured CE subgroup compared to the normal and EP subgroups. Consequently, the live birth rate was comparatively lower in the cured CE group than in both the control group and the EP group. Conclusions We found a high pregnancy loss rate in women with CE-confirmed immunohistochemically. While office hysteroscopy serves as a valuable diagnostic instrument, it is imperative that it be supplemented with appropriate and adequate antibiotic therapy. Further investigation is still required before it can be considered a standard infertile workup before the first embryo transfer in patients with previous ectopic pregnancy history. Trial registration N/A.