Since the risk for vertical and laboratory HCV infection is not well determined, and HCV prevalence is not negligible in this group, we recommend that infertile patients be screened before assisted reproductive techniques.
Objective
To determine the accuracy of hysterosalpingography compared with hysteroscopy for detection of intrauterine abnormalities in infertile patients.
Design
Cross‐sectional study.
Setting
University hospital.
Subjects
296 women undergoing an assisted fertilization programme.
Intervention
Patients Underwent to hysteroscopy and hysterosalpingography prior to intrauterine insemination or in vitro fertilization.
Main outcome measures
Hysterosalpingographic and hysteroscopic findings.
Results
Hysteroscopy proved satisfactory in 90.5% of cases. Of the patients, 121 (40.9%) had an abnormal hysteroscopic evaluation. The most prevalent hysteroscopic findings were: cervical stenosis (n = 28); chronic endometritis (n = 17); synechiae (n = 16); suspected endometrial hyperplasia (n = 14); polyps (n = 11); and myomas (n = 7). The comparison of hysteroscopic and hysterosalpingographic findings revealed a sensitivity of 75.21% and a specificity of 41.14% for hysterosalpingography; the positive and negative predictive values were 47% and 70.60%, respectively.
Conclusions
Hysterosalpingography is not sufficiently accurate, with regard to specificity or sensitivity, for screening pathologies of the endometrial cavity in infertile patients. Hysteroscopy should be performed in all patients before IVF and artificial insemination.
Purpose : In the present article we propose to evaluate IGF-1, IGFBP-1 and 3 in the follicular fluid of infertile patients submitted to in vitro fertilization. Methods : We performed a case-control study with 53 infertile patients submitted to the first in vitro fertilization attempt. We compared their follicular fluid concentration of IGF-1, IGFBP-1 and IGFBP-3 between the patients who became pregnant (n = 11) versus those nonpregnant (n = 42). Results : The clinical characteristics of patients from the two groups were similar in terms of age and body mass index. Data related to the analysis of ovulation induction was not different regarding length of induction in days, number of retrieved oocytes, fertilization rate, and number of transferred embryos. Furthermore, the number of FSH units required for ovarian induction was also similar between the studied groups.IGF-1 and IGFBP-1 were not significantly different between the groups (p > 0.05). However, those patients that became pregnant presented a lower follicular fluid concentration of IGFBP-3, 2237.10 ± 582.73 pg/ml and 2657.64 ± 584.15 ng/ml, respectively (p = 0.038). Conclusions : We demonstrated an association of a lower follicular fluid IGFBP-3 in individuals that became pregnant compared to subjects that did not after in vitro fertilization.
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