7 research outputs found
Fallopian tubal obstruction is associated with increased pain experienced during office hysteroscopy: a retrospective study
This study aimed at evaluating the pain experienced during office hysteroscopy, with selective tubal cannulation and chromopertubation,
by women with and without tubal obstruction in order to determine if such condition would be associated with
increased pain during the examination. Women with a history of infertility underwent in-office hysteroscopy with selective
chromopertubation using a continuous flow office hysteroscope with a 5 Fr operating channel fitted with a 4 Fr catheter
for the injection of methylene blue dye. Experienced pain was recorded on a Visual Analog Scale (VAS) during diagnostic
hysteroscopy after access to the uterine cavity. Of 90 women, 58 (66.4%) were found with at least one patent fallopian tube
and inserted in the group âanyâ, meanwhile 32 (33.6%) were categorized into group ânoneâ as both tubes were judged
obstructed. There was no significant difference between groups in BMI and primary infertility rate, but the difference was
significant concerning mean age (32.6 vs. 35.8; p < 0.001). The mean VAS score was 3.34 (± 1.07) in the group âanyâ and
4.25 (± 1.11) in ânoneâ. Comparing the VAS score of the two groups, the difference was significant (p < 0.001). Tubal occlusion
may have a potential role in the pain experienced by women undergoing in-office hysteroscopy. Women with bilateral
tubal occlusion experienced a higher level of pain compared with patients with at least one patent fallopian tube. Operators
may use milder intrauterine pressure of fluid distension medium when these patients are undergoing in-office hysteroscopy
to reduce discomfort.L
The effect of localization and histological verification of endometrial polyps on infertility
Aim
Our purpose is to investigate if transcervical resection of endometrial polyps improves the fertility in ovulatory infertile women, and whether polyp histology, intrauterine location, and the technique of polypectomy have any influence on the pregnancy rates.
Methods
In this retrospective study, clinical data of 87 ovulatory infertile women who underwent hysteroscopy and pol-ypectomy, and their 12-month follow-up have been analyzed. Subgroups according to the method of polyp removal (resec-toscope or curettage), the polyp localization (utero-tubal, anterior, posterior, lateral, multiple) and the histological result were interpreted.
Results
Mean age of patients was 33.99 ± 4.24 years. There were no differences in the BMI and basal FSH levels between the subgroups. Pregnancy was recorded in 30 (34.5%) within the next 12 months without any difference between the subgroups of polypectomy method applied. Posterior wall polyp resection increased the pregnancy chance (OR 5.02), but no other dif-ferences were observed in 1-year pregnancy rates to other localizations. Removal of polyps which had normal endometrial histology had lower pregnancy rates as compared to that of polyps with hyperplasia or endometrial polyp histology results (OR 0.25).
Conclusions
Polypectomy improved the conception rate in the subsequent year regardless of the intrauterine localization and the method of its surgical removal. Therefore, we can conclude that polypectomy should be considered in infertile women
Predictive value of bubble sign for tubal patency during office hysteroscopy
Objective: Our purpose was to investigate the predictive value of visible air bubble sign for real tubal patency during hysteroscopic procedures.
Methods: In this cross-sectional study, clinical data of 61 infertile women who underwent diagnostic hysteroscopy and laparoscopy have been analysed.
Results: Mean age of patients was 33.45 3.25 years. Bubble sign for the detection of patency demonstrated 73 % (95 % CI: 57â86 %) sensitivity, 70 % (95 % CI: 46â88 %) specificity, a positive predictive value of 83 % (95 % CI: 67â94 %), and a negative predictive value of 56 % (95 % CI: 35â76 %). Conclusions: A visible tubal âflowâ of air bubbles during hysteroscopy was not accurate in the prediction of tubal patency