Clinical Markers of Uterine Cavity Abnormalities Diagnosed by Office Hysteroscopy in an Infertile Population

ObjectiveThe aim of this study was to evaluate the diagnostic accuracy of hysteroscopic chromopertubation (HCT) in the assessment of tubal patency by comparing its results with laparoscopic chromopertubation (LCT).Study DesignThe population of this prospective cohort study consisted of both fertile and infertile women. Sixty-four women were included to the study. HCT was assessed by the observation of the transport of highly concentrated methylene blue from uterine cavity to tubal ostia. The results of HCT were compared with the results of LCT as a gold standard. The accuracy of HCT, sensitivity, specificity, positive and negative predictive values in diagnosing tubal patency were calculated.ResultsThe results of HCT and LCT were evaluated for right and left tubes, separately. One hundred and twenty-eight tubes were determined. Sensitivity, specificity, positive and negative predictive values for HCT were; 85.85%, 59.09%, 91% and 46.43%, respectively.Conclusion This study’s result showed that HCT had high sensitivity and moderate specificity values in the assessment of tubal patency. HCT during office hysteroscopy could give the chance to practitioners to assess tubal patency without subjecting the patient to multiple procedures.

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Three-dimensional Transvaginal Ultrasound vs Office Hysteroscopy for Assessment of Uterine Cavity in Assisted Reproductive Program

Journal of SAFOG with DVD ◽

10.5005/jp-journals-10006-1436 ◽

2016 ◽

Vol 8 (4) ◽

pp. 290-293

Author(s):

Ushma Patel

Keyword(s):

Predictive Value ◽

Transvaginal Ultrasound ◽

False Negative ◽

Three Dimensional ◽

Uterine Cavity ◽

Safe Procedure ◽

Office Hysteroscopy ◽

Diagnostic Efficacy ◽

Menstrual Cycles ◽

Negative Results

ABSTRACT Introduction The success of an assisted reproductive program (ARP) depends on the embryo quality and the intrauterine environment. It has been reported up until now that abnormal uterine findings occur in nearly 34 to 62% of infertile women worldwide. Due to this reason, uterine cavity evaluation is commonly recommended to screen for fibroids, polyps, adhesions, and mullerian abnormalities. Uterine cavity evaluation is usually accomplished with three-dimensional (3D) transvaginal ultrasound (TVS), sonohysterography, hysterosalpingography, and office hysteroscopy (OH). Materials and methods Uterine cavity evaluation was carried out in 239 infertile females undergoing ARP with twodimensional (2D) followed by 3D vaginal ultrasonography on day 21 of their menstrual cycles. Later, OH was carried out on 5th or 6th day of menstrual cycles. Results Out of 239 women, 3D TVS was abnormal in 28 (11.71%) and OH was abnormal in 53 (22.17%). Three-dimensional TVS agreed with OH in 16 (30.18%) abnormal cases and 179 (93.71%) normal cases. False-positive results for 3D TVS were 12 (6.28%) and false-negative results were 37 (69.81%). In our study, sensitivity of 3D TVS was 30.1%, specificity was 93.7%, positive predictive value was 57.1%, and negative predictive value was 82.8%. Conclusion Office hysteroscopy is an easy and safe procedure and has a better diagnostic efficacy than 3D TVS for uterine cavity evaluation in women undergoing ARP. How to cite this article Mishra VV, Patel U, Gandhi K. Threedimensional Transvaginal Ultrasound vs Office Hysteroscopy for Assessment of Uterine Cavity in Assisted Reproductive Program. J South Asian Feder Obst Gynae 2016;8(4):290-293.

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Office hysteroscopy prior to ART cycle-analysis and outcome at a private IVF clinic setup in Surat, Gujarat, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20170392 ◽

2017 ◽

Vol 6 (2) ◽

pp. 611

Author(s):

Meeta Mohan Mahale ◽

Purnima Kishore Nadkarni ◽

Kishore Mohan Nadkarni ◽

Pooja Prabhakar Singh ◽

Aditi Akshay Nadkarni ◽

...

Keyword(s):

Treatment Outcome ◽

Pregnancy Rate ◽

Multiple Pregnancy ◽

Uterine Cavity ◽

Standard Test ◽

Office Hysteroscopy ◽

Miscarriage Rate ◽

Infertile Women ◽

Diagnostic Hysteroscopy ◽

Multiple Pregnancy Rate

Background: Hysteroscopy is a gold standard test for assessing the uterine cavity. The presence of uterine pathology may negatively affect the chance of implantation .This study investigated the use of routine office hysteroscopy and correction of any intrauterine pathologies prior to starting IVF cycle on treatment outcome in women seeking IVF treatment for primary infertility and recurrent implantation failure.Methods: This was a retrospective study of 100 women who attended our infertility clinic from July 2016 to December 2016 and who were willing for office hysteroscopy. The main outcomes measured were clinical pregnancy rates achieved in the index IVF cycle, multiple pregnancy rate, ectopic pregnancy rate, miscarriage rate and failure rate.Results: Of the 100 patients who participated in the study, 75 patients conceived, 25 patients failed to conceive. 80.64% patients with normal findings on diagnostic hysteroscopy conceived after the procedure, 58.33% patients conceived after polypectomy, 68.42% conceived after septal resection, 71.42% conceived after adhesiolysis, 50% conceived after lateral metroplasty and 73.07% of recurrent implantation failure conceived after local endometrial injury was done on hysteroscopy.Conclusions: Hysteroscopy in infertile women prior to their IVF cycle when performed atleast 3 months in advance could improve treatment outcome.

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Povidone-iodine versus normal saline solution in preoperative vaginal cleansing before office hysteroscopy: a randomized controlled trial

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20175823 ◽

2017 ◽

Vol 7 (1) ◽

pp. 5

Author(s):

Ahmed M. Abbas ◽

Asmaa S. Shaltout ◽

Shymaa S. Ali ◽

Armia Michael ◽

Ahmed Altraigey ◽

...

Keyword(s):

Normal Saline ◽

Povidone Iodine ◽

Controlled Trial ◽

Uterine Cavity ◽

Office Hysteroscopy ◽

Postoperative Infections ◽

Postoperative Fever ◽

Group I ◽

Significant Difference ◽

The Difference

Background: Hysteroscopy is well-thought-out the gold standard for assessing the uterine cavity, and now can be done as an office process due to enhanced endoscopic advances with no need to in-patient admission. Objective of the present study was to compare the difference in the rate of postoperative vaginal irritation symptoms and postoperative infections after using povidone iodine (PI) and normal saline (NS) solution in vaginal cleaning before outpatient office hysteroscopy (OH).Methods: Women attended to the hospital for diagnostic OH were included for present study. Eligible women were randomly allocated in a 1:1 ratio to two groups. Group I "PI group" women exposed to PI for vaginal cleansing before hysteroscopy, and group II "NS group” women exposed to the NS solution for vaginal cleansing. The primary outcome of the study was to compare the difference in the rate of postoperative vaginal irritation symptoms and postoperative infections in both groups.Results: The mean age of the study participants was 34.26±4.14 years for NS group compared to 35.22±4.01 years for PI group (p=0.652). The PI group reported higher rate of vaginal irritation than NS group with no statistically significant difference between the two groups (p=0.179). Both groups were similar in postoperative fever, urinary tract infection and vaginitis (p>0.05).Conclusions: This study concluded that preoperative vaginal disinfection at the time of OH with a NS solution is less frequently causing postoperative vaginal irritation symptoms. Additionally, it is as effective as the usual agent (PI) in preventing postoperative infections.

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The effect of uterine cavity irrigation with office hysteroscopy during antagonist cycle 0varian stimulation on IVF outcome

10.26226/morressier.5af300b1738ab10027aa9748 ◽

2018 ◽

Author(s):

Marzieh Ghasemi

Keyword(s):

Uterine Cavity ◽

Ivf Outcome ◽

Office Hysteroscopy

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Office hysteroscopy: a new examination method in gynecological practice

Orvosi Hetilap ◽

10.1556/oh.2011.28997 ◽

2011 ◽

Vol 152 (2) ◽

pp. 51-54 ◽

Cited By ~ 1

Author(s):

Péter Török ◽

Tamás Major

Keyword(s):

Gold Standard ◽

Traditional Method ◽

Small Diameter ◽

Uterine Cavity ◽

Abnormal Uterine Bleeding ◽

Minimal Invasive ◽

Uterine Bleeding ◽

Office Hysteroscopy ◽

Examination Method ◽

Endoscopic Method

Hysteroscopy is a widely used endoscopic method, the „gold standard” for the examination of uterine cavity changes. Office hysteroscopy is an intervention that makes the accomplishment of ambulant examination, opposite to the traditional method. Due to the small diameter of the device the anesthesia is unnecessary, because there is no need of the dilatation of the cervix. Indications of the examination are wide-ranging. Besides the abnormal uterine bleeding, it can be used in the examination of infertility, and those intrauterine changes (polyp, submucosus myoma, adhesion), that were diagnosed by other imagining methods that cause infertility complaints. The aim of our present review is recommend the use of this method because it does not need any preparation and it is minimal invasive. The use of traditional method that needs longer preparation, observation, anesthesia and operating theatre, is only suggested in cases of proven pathology. Orv. Hetil., 2011, 152, 51–54.

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