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In Vitro Fertilization and Embryo Transfer
Published in Asim Kurjak, Ultrasound and Infertility, 2020
The terminal step in diagnosing infertility is hysterosalpingography and laparoscopy. These are invasive methods reserved for the end of the diagnostic process. Hysterosalpingography could provide valuable information on the uterine cavity, shape, and patency of the fallopian tubes. Laparoscopy, however, enables a close look into the lower pelvis where the extent of extrauterine and extratubal pathology can be observed and some minor adhesiolysis performed. Larger pathological changes will need more extensive operation of adhesiolysis and exposure of patients’ ovaries.
Habitual Abortion
Published in E. Nigel Harris, Thomas Exner, Graham R. V. Hughes, Ronald A. Asherson, Phospholipid-Binding Antibodies, 2020
Dwight D. Pridham, Christine L. Cook
Workup should begin with a careful history and physical, details of which appear in Table 3. Hysterosalpingography is useful in the detection of uterine lesions. We have found it beneficial to have these performed by one of the gynecologists in our group, so that information from the fluoroscopic portion of the exam is available in addition to hard copy films. Video recordings of the fluoroscopy may allow subsequent review and analysis. Optimal technique includes removing the speculum prior to making radiographs, to avoid obscuring the lower uterine cavity and cervix. The uterus should be pulled down by application of a tenaculum to the cervix, into a true anterior-posterior view to avoid missing fundal defects (septa, fibroids) that may be overlooked if the uterine cavity is viewed end on. Ultrasound examination of the uterus may provide adjunctive information, especially for fibroids. The relative position of the fibroid to the uterine cavity may be determined, which probably relates to the risk for HAB attributable to the fibroid. Hysteroscopy can confirm, and often treat intrauterine lesions.
Investigations in infertility
Published in David J Cahill, Practical Patient Management in Reproductive Medicine, 2019
Contrast ultrasonography. This is an ultrasound-based assessment, with the advantage that it can be done at any time of the cycle, unlike a hysterosalpingogram; it doesn't expose the woman to ionising radiation and is better tolerated than hysterosalpingography. It requires highly trained sonographers to obtain good-quality images. In my experience, it provides images which do not appear as crisp or clear compared to hysterosalpingography. However, with good sonography skills, it provides good sensitivity and specificity in the investigation of tubal function (17).
Lidocaine 10% sprays versus oral diclofenac sodium for pain relief in women undergoing hysterosalpingography for infertility workup: A randomized clinical trial
Published in Alexandria Journal of Medicine, 2023
Ayodeji Idowu, Akintunde O Fehintola, Mopelola c Ashaleye, Oluwole E Ayegbusi, Akinyosoye D Ajiboye, Olusegun O Badejoko, Kayode O Ajenifuja, Morebise O Loto
Tubal disease following pelvic inflammatory disease (PID), usually due to Neisseria gonorrhea and Chlamydia trachomatis is the commonest cause of female infertility in sub-Saharan Africa [4]. Hysterosalpingography is the primary investigation of choice in assessing the morphology of the cervix, uterus, and fallopian tubes in infertile women [5]. Gynecologists rely heavily on the information provided by hysterosalpingography in the evaluation of infertility. This procedure falls within the domain of both the gynecologist and radiologist. In the United State, 55% of hysterosalpingograms are obtained by the radiologists and gynecologists working together [6]. Either the balloon catheter or tenaculum cannula technique can be used. The major advantages of hysterosalpingography are its cost-effectiveness and outpatient nature.
Frequency and types of uterine anomalies during caesarean section
Published in Journal of Obstetrics and Gynaecology, 2019
Magdy A. Mohamed, Mohamed Y. AbdelRahman
Most of the anomalies in our study were septate and sub-septate uterus, representing about 71% of cases of congenital anomalies; however, a bicornuate uterus was encountered in about 19.4% of cases, while the incidence of unicornuate uterus was 6.4%. Only one case of uterine didelphys was reported, representing only 3.2% of congenital anomalies of the uterus. The incidence of septate and subseptate uteri was slightly higher than that reported by Raga et al. (1997), who reported a frequency of 66% of cases. This may be explained by the retrospective nature of their study and the fact that they included infertile patients. In addition, they depended on hysterosalpingography in some cases to reach a diagnosis.
Prognostic value of hysterosalpingography after salpingostomy in patients with hydrosalpinx
Published in Journal of Obstetrics and Gynaecology, 2023
Wen-Xi Yao, Du-Zhou Zheng, Wei-Feng Liu, Mi-Mi Zhou, Li Liu, Ming-Jin Cai
To date, studies assessing fallopian tube improvement after laparoscopic salpingostomy in patients with hydrosalpinx are scarce, although this could lead to better pregnancy rate and outcome. Such evaluation could be performed by hysterosalpingography (HSG), providing insights into individualised management of these patients (Juneau and Bates 2012, Katler et al.2018). Therefore, the aim of this study was to examine whether postoperative evaluation by hysterosalpingography is associated with pregnancy rate, and to identify independent risk factors for successful pregnancy after salpingostomy in patients with hydrosalpinx.