Effect of Hydrotubation in Unexplained Infertility – A Randomized Controlled Trial

Abstract

<p>Unexplained infertility is a major gynecological problem with complex etiolgy. Partial tubal blockage with inflammatory reaction and thick mucus plugs in fallopian tubes and cervix is one of the likely causes in such cases. This study is based on the hypothesis that women having unexplained infertility could be helped by transcervical flushing of fluid through the fallopian tubes which would remove reversible blocking factors and help in achieving pregnancy.</p><p><strong>Objective:</strong><strong>Â Â </strong>To compare the outcome of hydrotubation<br /> in unexplained infertility in clomiphene citrate stimulated cycles with control group (no Hydrotubation).</p><p><strong>Setting:</strong><strong>Â Â </strong>Infertility Centre of a Public Sector Hospital.</p><p><strong>Study Design:</strong><strong>Â Â </strong>A two years Prospective randomized controlled trial from Jan 2014 to Dec 2015.</p><p><strong>Method:</strong><strong>Â Â </strong>128 women participated in the study. Participants were divided into study and control group with 64 members in each group. Ovulation induction was done with clomiphene citrate in all the participants and confirmed by ovulation detection strips and follicular tracking on Ultrasonography. 50 cc cocktail of inject-ion (inj.) kanamycin 1 gm, inj. hydrocortisone and normal saline was injected transcervically in study group for three consecutive days from the next day after end of menstruation. No hydrotubation was done in control group. Main outcome measures were number of conceptions within next 3 cycles and complications of hydrotubation.</p><p><strong>Results:</strong><strong>Â Â </strong>In hydrotubation group, 20 women conceived. Out of these, 14 women conceived in the same cycle in which hydrotubation was done while 6 pregnancies occurred in subsequent cycle. 4 pregnancies occurred in the control group. Complications of hydrotubation were mild abdominal pain (59 women), vomiting (49 women) and Per vaginum bleeding (18 women). There were significantly more pregnancies in women who experienced right shoulder tip pain after the procedure.</p><p><strong>Conclusion:</strong><strong>Â Â </strong>In women with unexplained infertility, tubal hydration can increase conception rate and decrease the time to achieve pregnancy.</p><p>Â </p>

Genitourinary / Fecal Fistulae: Etiology, Types and Surgical Outcomes

“…One patient of ureteric fistula was managed by passing DJ stent through cystoscopy and stent was removed after 6 weeks with complete recovery. The success rate of ureteric fistula in our study was 100% which is comparable with other studies as well 20,25 . In our study, the most common cause of ureteric fistula was abdominal hysterectomy and same finding was seen in other study 25 .…”

“…Vesico-vaginal fistula was the most common type among all genitourinary fistulae accounting for 64-78% in various studies 20,21,22 .In our study the second most common type was uretero-vaginal fistula accounting for 10% of all varieties. Similar incidence was found in other study 20 .Priyadarshi et al quoted the frequency of uretero-vaginal fistula as 14% 21 . In our study vaginal route of repair was adopted in 46 (59.74%) cases and 28 (36.6%) had abdominal route of repair.…”

Ultrasonographic Hydrotubation versus No Hydrotubation Before Intrauterine Insemination

“…The current results were supported by Saaqib et al 7 who reported that Hydrotubation was shown to be successful in improving fertility in unexplained instances, and right shoulder tip discomfort was proven to be a statistically useful indicator for predicting pregnancy. They also stated that the majority of the patients conceived during the same cycle as hydrotubation.…”

“…As well, our study was further supported by Prospective randomized controlled trial of Saaqib et al 7 compare the results of hydrotubation in cases of unexplained infertility in clomiphene citratestimulated cycles to the results of a control group (no Hydrotubation). The research involved 128 women, including 64 women in each of the experimental and control groups.…”