"Chromohysteroscopy" for evaluation of endometrium in recurrent in vitro fertilization failure.

PURPOSE: To assess the efficacy of chromohysteroscopy in detecting endometrial pathologies in recurrent in vitro fertilization (IVF) failure.

MATERIALS AND

METHODS

Sixty-four patients in whom conventional hysteroscopy did not show any apparent endometrial pathology were included. Five milliliter of 1% methylene blue dye was introduced through the hysteroscopic inlet. Biopsies were obtained both from dark stained and light stained areas.

RESULTS

The study group was grouped according to the staining characteristics. Group I included 22 patients in whom focal dark staining was observed. Group II included 41 patients in whom diffuse light blue staining without dark areas was observed. There was no significant difference between two groups in age, smoking, body mass index, number of IVF failure and time to hysteroscopy after the last failure. But, there was a statistically significant difference in the incidence of endometritis between two groups (p=0.007). The power of dark staining for detection of endometritis was calculated as follows: sensitivity 69.2%, specificity 74%, positive predictive value 40.9% and negative predictive value 90.2%.

CONCLUSION

Chromohysteroscopy improves the efficacy of hysteroscopy in recurrent IVF failure. Observation of diffuse light blue staining without dark areas strongly suggests a normal endometrium free of endometritis.