The purpose of this study was to compare the reproductive outcome of ultrasound-guided (USG) embryo transfers versus clinical touch embryo transfers. A statistically powered retrospective analysis of women undergoing fresh and frozen embryo transfers in a National Health Service-based tertiary referral centre in the Department of Reproductive Medicine, St Mary's Hospital, Manchester was carried out. A total of 1723 embryo transfers were included in the analysis. The implantation rate was significantly higher in the USG embryo transfer group compared with the non-USG embryo transfer group (fresh: 19.9 versus 9.5%, P < 0.0001; frozen: 13.1 versus 7.3%, P < 0.0004). The clinical pregnancy rate was also significantly higher in the former group (fresh: 26.9 versus 12.5%, P < 0.0001; frozen: 15.6 versus 8.9%, P < 0.0015). For the frozen embryos, the miscarriage rate was significantly elevated among the USG embryo transfer group [unadjusted rate ratio (RR) = 1.65, 95% CI: 1.04, 2.62], but this was of borderline significance when the model was adjusted for the potential confounders (adjusted RR = 1.56, 95% CI: 0.997, 2.45). There was no difference in the ectopic pregnancy rates between the two groups. The findings of this study show that the practice of USG embryo transfer is associated with statistically higher implantation and clinical pregnancy rates in IVF.
The Royal College of Obstetricians and Gynaecologists (RCOG) published guidelines describing the management of menorrhagia in primary and secondary care. In this study, we reviewed retrospectively, the compliance with these guidelines in women who underwent a hysterectomy for menorrhagia over a 3-year period in a District General Hospital. Case notes were reviewed for 22 women in whom the uterus was reported normal on histology. There was a high level of compliance in clinical assessment before hysterectomy. Nearly 70% of women received some form of medical treatment, however only 50% were offered endometrial ablation. Compliance was high in imparting information about the risk factors of hysterectomy and in administering thromboprophylaxis.
Introduction: Antral follicle count has been found to be a useful predictor of pregnancy outcome in patients undergoing in-vitro fertilisation (IVF), but the examination using 2D ultrasound is time consuming and consistent results may be difficult to obtain. Objective: To evaluate the usefulness of inversion mode for antral follicle count using the GE 4D View software. Method: 100 patients undergoing IVF were recruited. Antral follicle count was performed on 2 nd day of the menstrual cycle using conventional TV 2D scanning, followed by 3D TV scanning on GE Voluson 730 Pro V ultrasound system. While on conventional 2D scanning, the antral follicles in each ovary were counted and classified into the following groups : (a) less than 4 mm (b) 4-7 mm (c) 8-11 mm. The scanning duration of antral follicle count was recorded. The patient was sent home before analyses of the 3D volume data were carried out. The 3D volume data in the GE Voluson 730 Pro V system was transferred to a CD. Off-line analyses were carried out using the 4D view software in a PC. The inversion mode was utilised on the rendered image, the chroma was set on 'copper' tone. The follicles were counted by rotating along the X and Y axes. They were classified into groupings similar to that done on 2D TV scans. The duration of antral follicle count for each patient using the inversion mode was recorded. Results: With the conventional 2D transvaginal technique, the examination time ranged form 5-10 minutes for each ovary. The timing required for the 3D inversion mode technique was almost the same, but the patient need not be present when the counting was in progress. This significantly reduced the discomfort for the patient and the stress on the sonographer.
Conclusion:The inversion mode is a useful tool in antral follicle count. It can be used in any PC installed with GE 4D view.
P41.03An obsolete 25-year-old Chinese ring intrauterine device: Applications of three dimensional sonography to determine its presence and location
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