- 作者：Sherif M.M. Negm ; MD ; sherifnegm@hotmail.com ; Rasha A. Kamel ; MD ; Fouad A. Abuhamila ; MD
- 关键词：Three dimensional ultrasound ; Sonohysterography ; Vaginoscopic hysteroscopy ; Recurrent implantation failure ; in vitro fertilization
- 刊名：Journal of Minimally Invasive Gynecology
- 出版年：2012
- 出版时间：July-August, 2012
- 年：2012
- 卷：19
- 期：4
- 页码：503-508
- 全文大小：550 K
Study Objective
To estimate the degree of agreement between 3-dimensional sonohysterography (3D-SHG) and vaginoscopic hysteroscopy (VH) in detection of uterine cavity abnormalities in patients with recurrent implantation failure in in?vitro fertilization cycles.Design
Comparative observational cross-sectional study (Canadian Task Force classification II-1).
Setting
Private assisted-conception unit.
Patients
One hundred forty-three patients with a history of at least 2 previous implantation failures despite transfer of good quality embryos in assisted-conception cycles.
Interventions
3D-SHG was followed by VH. The Cohen ¦Ê for interrater agreement was calculated for the level of agreement between the 2 diagnostic procedures. Procedure time in seconds was recorded for both procedures. Patients were asked to rate their degree of discomfort or pain during both procedures using a visual analog scale.
Measurements and Main Results
There was a substantial degree of concordance between 3D-SHG and VH (¦Ê = 0.77; 95 % confidence interval, 0.6-0.84). The median procedure time for 3D-SHG was 296 seconds (range, 231-327 seconds), and for VH was 315 seconds (range, 232-361 seconds), and the difference was statistically significant (p =.02). The visual analog scale pain scores also showed that 3D-SHG, with a median pain score of 2.1 (range, 1-3) was better tolerated than VH, with a median pain score of 2.9 (range, 2-4) (p < .001).
Conclusion
Our results show that there is a substantial degree of concordance between 3D-SHG and VH in diagnosing uterine cavity anomalies. We also found that 3D-SHG took significantly less time and induced less patient discomfort than did VH. We recommend that 3D-SHG should be the method of first choice for outpatient evaluation of the uterine cavity.