Spontaneous pregnancy rate after saline infusion sonogram treat done under high pressure
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20196029Keywords:
Cumulative pregnancy rate, Infertility, Saline infusion sonogram, Transvaginal ultrasound, Tubal factorAbstract
Background: Failure to achieve conception after 12 months of regular unprotected intercourse is defined as infertility. The aim of this study was evaluating SIS done under high pressure (SIStreat) as a treatment procedure, for relieving simple tubal obstruction and on cumulative pregnancy rate in infertile women.
Methods: A prospective, interventional trial was done (October 2017 - November 2018) on 106 eligible women. All patients performed SIS. Patient with tubes patent under low pressure were assigned as control group, the rest of them were subjected to SIStreat, this group was farther divided into Group 2-a (patent under high pressure) and Group 2-b (occluded under high pressure). All patients had regular intercourse for 6 months. Pregnancy was confirmed by serum B-HCG.
Results: we compared patients who performed conventional SIS (n = 100 cases) to patients who performed SIStreat afterwards (n = 84) according to the number of patent tubes. There was a high statistically significant difference in favor of SIStreat group (p < 0.001). Also, there was no significant difference in pregnancy rate between control group 62.5% and Group 2-a 45.7% (p = 0.226).
Conclusions: SIStreat is a whole new procedure for opening fallopian tubes (diagnosed occluded by SIS). Patients who were successfully treated by SIStreat had cumulative pregnancy rate comparable to patients who were diagnosed to have patent tubes using conventional SIS.
References
ESHRE Capri Workshop Group. Diagnosis and management of the infertile couple: missing information. Hum Reprod Update. 2004;10:295-307.
Kupesic S, Kurjak A. Interventional ultrasound in human reproduction. In: Kupesic S, De Ziegler D, editors. Ultrasound and Infertility. New York, NY: Parthenon Publishing; 2000:253-263.
National Institute for Health and Clinical Excellence: Fertility: assessment and treatment for people with fertility problems. Nice clinical guideline 156; 2013. Available at: guidance.nice.org.uk/cg156.
Exacoustos C, Zupi E, Carusotti C, Lanzi G, Marconi D, Arduini D. Hystero-salpingo-contrast-sonography compared with hysterosalpingography and laparoscopic dye perturbation to evaluate tubal patency. J Am Assoc Gynecol Laparosc. 2003;10:29-32.
Dietrich M, Suren A, Hinney B, Osmers R, Kuhn W. Evaluation of tubal patency by hysterocontrast sonography (HyCoSy, Echovist) and its correlation with laparoscopic findings. J Clin Ultrasound. 1996;24:523-7.
Testa AC, Ferrandina G, Fruscella E, Van Holsbeke C, Ferrazzi E, Leone FP, et al. The use of contrasted transvaginal sonography in the diagnosis of gynecologic diseases: a preliminary study. J Ultrasound Med. 2005;24:1267-78.
Bonilla-Musoles F, Simon C, Serra V, Sampaio M, Pellicer A. An assessment of hysterosalpingosonography (HSSG) as a diagnostic tool for uterine cavity defects and tubal patency. J Clin Ultrasound. 1992;20:175-81.
Parsons AK, lense JJ. Sonohysterography for endometrial abnormalities: preliminary results. J Clin Ultrasound. 1993;21:87-95.
Goldstein SR. Saline infusion sonohysterography. Clin Obstet Gynecol. 1996;39:248-58.
Hajishafiha M, Zobairi T, Zanjani VR, Ghasemi-Rad M, Yekta Z, Mladkova N. Diagnostic value of sonohysterography in the determination of fallopian tube patency as an initial step of routine infertility assessment. J Ultrasound Med. 2009;28(12):1671-7.
Malek-Mellouli M, Gharbi H, Reziga H. The value of sonohysterography in the diagnosis of tubal patency among infertile patients. Tunis Med. 2013;91(6):387-90.
Saunders RD, Shwayder JM, Nakajima ST. Current methods of tubal patency assessment. Fertil Steril. 2011;95:2171-9.
Dessole S, Farina M, Rubattu G, Cosmi E, Ambrosini G, Nardelli GB. Side effects and complications of sonohysterosalpingography. Fertil Steril. 2003;80(3):620-4.
Kotz S, Balakrishnan N, Read CB, Vidakovic B. Encyclopedia of statistical sciences. 2nd ed. Hoboken, N.J.: Wiley-Interscience; 2006.
Kirkpatrick LA, Feeney BC. A simple guide to IBM SPSS statistics for version 20.0. Student ed. Belmont, Calif.: Wadsworth, Cengage Learning; 2013.
Strandell A, Waldenström U, Nilsson L, Hamberger L. Hydrosalpinx reduces in-vitro fertilization/embryo transfer pregnancy rates. Human Repro. 1994;9(5):861-3.
Berek JS. Berek and Novak’s Gynecology. 14th ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2007.
Wang R, van Welie N, van Rijswijk J, Johnson NP, Norman RJ, Dreyer K, et al. Effectiveness on fertility outcome of tubal flushing with different contrast media: systematic review and network meta-analysis. Ultrasound Obstet Gynecol 2019;54:172-81.
Sefa K, Ciragil G, Yücel B, Gencdal S, Destegul E, Ozdemir O. Saline infusion sonography can improve outcome in subsequent ICSI cycles when no intrauterine pathology is detected. J Reprod Med. 2016;61(5):421-4.
Zhou L, Li R, Wang R, Huang HX, Zhong K. Local injury to the endometrium in controlled ovarian hyperstimulation cycles improves implantation rates. Fertil Steril. 2008;89:1166-76.
Sherer DM, Abulafia O. Angiogenesis during implantation, and placental and early embryonic development. Placenta. 2001;22:1-3.
Mirkin S, Nikas G, Hsiu JG, Díaz J, Oehninger S. Gene expression profiles and struc-tural/functional features of the peri-implantation endometrium in natural and gonadotropin-stimulated cycles. J Clin Endocrinol Metab. 2004;89:5742-52.
Soares SR, Barbosa dos Reis MMB, Camargos AF. Diagnostic accuracy of sonohysterography, transvaginal sonography, and hysterosalpingography in patients with uterine cavity diseases. Fertil Steril. 2000;73:406-11.
Inki P, Palo P, Antlia L. Vaginal sonosalpingography in the evaluation of tubal patency. Acta Obstet Gynecol Scand. 1998;77:975-82.
Romano F, Cicinelli E, Anastasio PS, Epifani S, Fanelli F, Galantino P. Sonohysterography versus hysteroscopy for diagnosing endouterine abnormalities in fertile women. Int J Gynecol Obstet. 1994;45:253-60.
