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Açıklanmayan İnfertilite Vakalarında HSG'de Kullanılan Ajanların Fertilite Üzerine Etkileri

The Effects of HSG Media on Fertility in Unexplained Infertility Cases

Journal Name:

  • Fırat Tıp Dergisi

Publication Year:

  • 2004

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Objective: Investigation of the effects of liposoluble / watersoluble contrast media used in hysterosalpyngography on fertility in unexplained infertility cases. Material and Method: Sixty primary or secondary infertile cases diagnosed as unexplained infertility were retrieved from the entire infertility cases admitted between June 1998 -March 2001 and they were analyzed by randomized, prospective, single blinded method and classified as the study group (G1=n:30, Lipiodol) and the control group (G2=n:30, Urovision). Hysterosalpyngography was provided two days after the end of menses. The patients who were diagnosed as unexplained infertility and with normal basal clinical and laboratory investigations for infertility have been just monitered for over three months after hysterosalpyngography was done. They were suggested to return back when menstruation delay occur. If pregnancy not achieved over 3 months patients directed for ovulation induction with clomiphene citrate + intrauterine insemination. Statistically Student T test, Mann Whitney U test and X2 were used for continous, ordinal and nominal data, respectively. P value<0.05 was found significant and relative risk (%95 CI) was calculated. Results: Rate of pregnancy was found to be 43.7% in study group whereas 10% in control group (p=0.007, X2 test, RR=4, %95 CI=1.3-13). Lipiodol is more efficacious in secondary infertility cases and pregnancy rate was 55% in comparison to 5% (p=0.001, X2test, RR=11, %95 CI=1.5-77). No complication (vasovagal reaction, seizure, anaphylaxis, intravasation, embolus) was encountered during hysterosalpyngography. One secondary infertile case who was excluded from the study due to the failure of bilateral tubal passage during lipiodol hysterosalpingograpy; therefore not considered as an unexplained case . Conclusion: Liposoluble contrast media used in infertility cases during hysterosalpyngography increase the rate of pregnancy significantly in respect to water soluble agents. This effect is much obvious particularly in secondary infertility cases. Use of liposoluble media can be proposed in unexplained cases.©2004, Fırat Üniversitesi, Tıp Fakültesi
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Abstract (Original Language): 
Amaç: Açıklanamayan infertilite vakalarında histerosalpingografide kullanılan yağda ve suda çözünür ilaçların etkisinin araştırılması. Gereç ve Yöntem: Haziran 1998 - Mart 2001 yılları arasında primer veya sekonder infetilite tanısı almış 60 hasta tek kör, prospektif randomize olarak çalışma grubu (G1=n:30, Lipiodol) ve kontrol grubu olarak (G2=n:30, Urovision) sınıflandırıldı. Menstruasyon bitiminden iki gün sonra bütün hastalara histerosalpingografi uygulandı. İnfertilite araştırması nedeniyle yapılan bazal klinik ve labaratuar tetkikleri normal olan infertil hastalar histerosalpingografi sonrasında 3 ay boyunca takip edildi. Menstruasyon rötarı olanlar gebelik tanısı için çağrıldı. İşlemden 3 ay sonra gebelik elde edilmeyen hastalar klomifen sitrat ile ovulasyon indüksiyonu ve intrauterin inseminasyona yönlendirildi. İstatistiksel hesaplamalar Student T test, Mann Whitney U test ve X2 testleri kullanılarak yapıldı. p<0.05 anlamlı olarak kabul edildi ve rölatif risk (%95 CI) hesaplandı. Bulgular: Gebelik oranı çalışma grubunda 43.7% , kontrol grubunda ise 10% olarak bulundu (p=0.007, X2 test, RR=4, %95 CI=1.3-13). Sekonder infertilite vakalarında Lipiodol daha etkili bulundu ve gebelik oranı çalışma grubunda %55 kontrol grubunda ise %5 olarak bulundu (p=0.001, X2test, RR=11, %95 CI=1.5-77). Histerosalpingografi sırasında olası herhangi bir komplikasyon (vazovagal reaksiyon, konvülsyon, anaflaksi, emboli gibi,) ile karşılaşılmadı. Bilateral tubal pasaj tıkanıklığı olan bir vaka açıklanamayan infertilite olmadığından çalışmadan çıkarıldı. Sonuç: İnfertilite vakalarında yağda çözünür kontrast maddelerle yapılan histerosalpingografi sonrası gebelik oranı suda çözünür maddelerle yapılanlara göre oldukça fazla tespit edildi. Bu etki özellikle sekonder infertilite vakalarında gözükmektedir. Açıklanamayan infertilite vakalarında yağda çözünen kontrast maddeler önerilebilir. ©2004, Fırat Üniversitesi, Tıp Fakültesi
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