HMB had significant repercussions in the social, medical and economic aspects of women. The impact on the QoL was associated with the hematimetric parameters.

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The present study aimed to correlate morphometric parameters of the oocytes with the occurrence of fertilization following intracytoplasmic sperm injection (ICSI). In a prospective, controlled cohort design, women (n = 32) who were candidates for ICSI had oocytes (n = 258) collected and submitted to morphometric evaluation using the Cronus3 software program. The morphometric parameters obtained were oocyte diameter, perivitelline space width, zona pellucida thickness, and first polar body diameter. The median oocyte diameter was similar in cases in which fertilization occurred compared with those in which fertilization failed (75.2 and 75.9 μm, respectively; P = .218). The 2 groups also had similar measurements of perivitelline space, zona pellucida, and first polar body. However, the best quality zygotes identified by a morphological score resulted from oocytes with larger diameter (75.6 vs 74.0 μm; P < .01) and narrow perivitelline space (5.3 vs 7.1 μm; P < .01). Embryo development, as assessed by cleavage at second day of culture, was not significantly associated with oocyte morphometric parameters. These findings suggest that morphometric parameters of the oocytes do not correlate with the occurrence of fertilization following ICSI but may assist in selecting oocytes more likely to originate high-quality zygotes.

Objective:The aim of this study was to verify the prevalence of uterine cavity abnormalities diagnosed by routine office hysteroscopy in women preparing to IVF.Methods:We carried out a retrospective cross-sectional study of 1141 consecutive women who underwent outpatient hysteroscopy before IVF at a tertiary academic center. Of these, 961 participants had a normal transvaginal sonography (TVS) of the uterine cavity. The prevalence of hysteroscopic alterations in successive age strata was submitted to Mantel-Haenzsel Chi-square test for linear trend. The diagnostic accuracy of TVS using hysteroscopy as reference was assessed by calculating the sensitivity, specificity, positive and negative likelihood ratios.Results:Hysteroscopic alterations were present in 265/961 of patients with a negative TVS (prevalence 27.6%, 95% confidence interval [CI] 24.8%-30.5%). The prevalence of unsuspected submucous leiomyoma was higher among older women (p=0.005, chi-square test for linear trend) and reached 7.2% (95% CI 3.5%-14.1%) after 40 years. The sensitivity of TVS ranged from 8% (95% CI 2%-20%) for uterine synechiae to 41% (95% CI 28%-56%) for submucous leiomyoma, resulting in low likelihood ratios for negative TVS results.Conclusions:These findings suggest a high prevalence of unsuspected alterations found by routine hysteroscopy before IVF, an age-dependent increase in the frequency of submucous leiomyoma and a low diagnostic sensitivity of TVS to detect intracavitary lesions.

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Introduction: Hysteroscopy is considered the gold standard in the evaluation of the uterus and its diseases. Its use as a diagnostic technique is an outpatient procedure, usually well tolerated by patients, allowing resumption of activities right after its completion. The teaching of the hysteroscopic technique tends to be time consuming, with a slow learning curve. Therefore, defining the impact of the histeroscopy's learning curve on the intensity of the pain felt by the patients can help improving the organization of hysteroscopy services, maximizing learning and reducing patient discomfort. Objectives: To analyze, with the construction of a learning curve, the possible relationship between the number of hysteroscopic procedures performed by the doctor and the intensity of pain reported by the patient during the exam. Methods: A prospective cohort study with 403 patients who underwent hysteroscopy in the Hospital Universitário São José (HUSJ). Results: 72.45% of the patients rated the pain as mild and 5.95% , as strong. Furthermore, Correlation between the learning curve and the pain reported by the patient during outpatient hysteroscopy procedure without anesthesia

objectives: To evaluate the impact of previous guidance on the hysteroscopy exam using multimedia resources (film) compared to verbal orientations only, on the pain intensity perceived by the patient during hysteroscopy without anesthesia. Methods: Randomized clinical trial, which included 187 women, who were referred for hysteroscopy. The patients in the experimental group (89) watched an explanatory video just before the exam. The control group (98), however, received only routine verbal guidance about the exam. The degree of pain perceived by all patients was measured 1 and 5 minutes after the procedure using Visual Analog Scale. results: In the experimental group, 1 minute after the examination, 29.2% of the patients reported mild pain, 24.7% moderate pain and 46.1% severe pain. In the control group, 28.6% of the patients reported mild pain, 29.6% moderate pain and 41.8% severe pain. In the analysis 5 minutes after the examination of the experimental group 60.7% of the patients reported mild pain, 28.1% moderate pain and 11.2% severe pain and the control group 62.3% of the patients reported mild pain, 26.5% moderate pain and 11.2% severe pain. Conclusions: The study was not able to demonstrate the relationship of pain perceived by patients with prior multimedia orientation, thus that, more studies are needed.