1. THE ROLE of INTRAUTERINE SYNECHIAES in REPEATING IMPLANTATION FAILURE
Dr. Firdevs Şekerci Baran

2. PURPOSE
Intrauterine synechiaes may occur after spontaneus abortion without curettage history,
This synechiaes may cause in repeated invitro fertilization (IVF) failure.

3. CASE A 36 year old 5 year infertile woman IVF twice at various centers
None of them were successful
The cause of infertility was researched again

4. CASE Spermiogram was normal.
Bilateral hydrosalpinx was detected in the patient with HSG and ultrasound.
After 3 months from laparoscopic tubal ligation operation, IVF planned.

5. CASE
IVF was successful but spontaneus abortion occured at 14 weeks of gestation.
Curettage was not done because there was no material in the uterine cavity.
After 6 months of abortion, the patient underwent freezing embryo transfer  3 times at intervals of 3 months,
But no successful results were obtained.

6. CASE After 3 unsuccessful IVF cycle, HSG was done.
İntrauterine synechiaes especially in the fundal region were detected.

7. Fundal synechiaes

8. CASE
After the  intrauterine synechiae were seen, operative hysteroscopy was performed
The synechiaes were rezected.
IVF was planned one month after the operation,
10. days of embryo transfer (again freezing transfer), B-hCG was positive.

9. CASE Because of breech presentation,
Cesarean section was performed on the 39 week of the pregnancy.
A live 3650 gr male baby was born. 

10. CONCLUSİON
If there is an abortion history in the recurrent implantation failure there may be an  intrauterine synechiae with or without an curettage history.

11. CONCLUSİON Before new IVF treatment,
The patient should be evaluated for intrauterine synechiae with HSG and hysteroscopy.

12. REFERANCES
Vujovic M, Garalejic E, Arsic B, Zamurovic M, Perovic M. Hysterosalpingography versus hysterescopy in intrauterine patology research of infertile patients.Clin Exp Obstet Gynecol 2015; 42(2):
Kodaman PH, Arici A. İntrauterine adhesions and fertility outcome: how to optimize success? Curr Opin Obstet Gynecol Jun;19 (3): Review.