Hysteroscopy before in-vitro fertilisation (inSIGHT): a multicentre, randomised controlled trial

Summary Background Hysteroscopy is often done in infertile women starting in-vitro fertilisation (IVF) to improve their chance of having a baby. However, no data are available from randomised controlled trials to support this practice. We aimed to assess whether routine hysteroscopy before the first...

Full description

Saved in:
Bibliographic Details
Published in:The Lancet (British edition) 2016-06, Vol.387 (10038), p.2622-2629
Main Authors: Smit, Janine G, MD, Kasius, Jenneke C, PhD, Eijkemans, Marinus J C, Prof, Koks, Carolien A M, PhD, van Golde, Ronald, PhD, Nap, Annemiek W, PhD, Scheffer, Gabrielle J, PhD, Manger, Petra A P, PhD, Hoek, Annemieke, PhD, Schoot, Benedictus C, PhD, van Heusden, Arne M, PhD, Kuchenbecker, Walter K H, PhD, Perquin, Denise A M, PhD, Fleischer, Kathrin, PhD, Kaaijk, Eugenie M, PhD, Sluijmer, Alexander, PhD, Friederich, Jaap, PhD, Dykgraaf, Ramon H M, van Hooff, Marcel, PhD, Louwe, Leonie A, MD, Kwee, Janet, PhD, de Koning, Corry H, Janssen, Ineke C A H, PhD, Mol, Femke, PhD, Mol, Ben W J, Prof, Broekmans, Frank J M, Prof, Torrance, Helen L, PhD
Format: Article
Language:English
Subjects:
Abnormalities
Adult
Ambulatory Surgical Procedures
Clinical trials
Consortia
Endometritis
Evidence-based medicine
Female
Fertilization
Fertilization in Vitro
Fetuses
Gestation
Hospitals
Humans
Hysteroscopy
In vitro fertilization
Infertility
Infertility, Female - therapy
Internal Medicine
Live Birth
Medical personnel
Medical procedures
Meta-analysis
Netherlands
Nurses
Physical examinations
Physicians
Pregnancy
R&D
Randomization
Reproductive technologies
Research & development
Sperm
Time Factors
Treatment Outcome
Ultrasonic imaging
Ultrasound
Uterus
Womens health
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Summary Background Hysteroscopy is often done in infertile women starting in-vitro fertilisation (IVF) to improve their chance of having a baby. However, no data are available from randomised controlled trials to support this practice. We aimed to assess whether routine hysteroscopy before the first IVF treatment cycle increases the rate of livebirths. Methods We did a pragmatic, multicentre, randomised controlled trial in seven university hospitals and 15 large general hospitals in the Netherlands. Women with a normal transvaginal ultrasound of the uterine cavity and no previous hysteroscopy who were scheduled for their first IVF treatment were randomly assigned (1:1) to either hysteroscopy with treatment of detected intracavitary abnormalities before starting IVF (hysteroscopy group) or immediate start of the IVF treatment (immediate IVF group). Randomisation was done with web-based concealed allocation and was stratified by centre with variable block sizes. Participants, doctors, and outcome assessors were not masked to the assigned group. The primary outcome was ongoing pregnancy (detection of a fetal heartbeat at >12 weeks of gestation) within 18 months of randomisation and resulting in livebirth. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov , number NCT01242852. Findings Between May 25, 2011, and Aug 27, 2013, we randomly assigned 750 women to receive either hysteroscopy (n=373) or immediate IVF (n=377). 209 (57%) of 369 women eligible for assessment in the hysteroscopy group and 200 (54%) of 373 in the immediate IVF group had a livebirth from a pregnancy during the trial period (relative risk 1·06, 95% CI 0·93–1·20; p=0·41). One (
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(16)00231-2