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Açıklanamayan İnfertilitesi olan Kadınlarda Ofis Histereskopi:En Sık Saptanan Anormal Histereskopik Bulgular

Year 2018, Volume: 49 Issue: 1, 140 - 143, 04.04.2018
https://doi.org/10.16948/zktipb.360699

Abstract

Amaç: Açıklanamayan primer ve sekonder infertil  olan kadınlarda servikal  kanal ve uterin kaviteyi ofis histereskopi (H/S) ile
değerlendirerek  bu hastalardaki
intrauterin  anormal bulgu sıklığını
belirlemektir.

Gereç ve
yöntem:
Bu çalışma Harran
Ünüversitesi  Üremeye  Yardımcı 
Tedavi Merkezimize Aralık 2016 ve 
Ekim 2017 tarihleri arasında  başvuran  açıklanamayan infertilitesi olan ve daha önce
ofis histeroskopyi yapılmamış  toplam
102  primer ve sekonder infertil hastanın
dahil edildiği retrospektif bir çalışmadır.  Hastaların yaş,infertilite tipi, infertilite
süresi ,vücut kitle indexi (VKİ) komplikasyon ve histereskopik bulguları hasta
dosyalarından kaydedildi. Hastalar 
20-30, 31-35, 36-40  yaş infertil
kadınlar şeklinde  3 gruba ayrıldı. 20 -30
yaş grubu genç yaş, diğer yaş gruplarını ileri yaş grubu olarak kabul edildi.
İnfertilite türüne ve yaşa göre en sık anormal histereskopik  bulgular saptandı. Ofis histereskopi işlemi
deneyimli 3 hekim tarafından gerçekleştirildi.

Bulgular: Ofis histereskopi yapılan hastaların   81.37% (83/102) primer infertil, 18.63%
(19/102) ü sekonder infertil idi. Açıklanamayan infertilitesi olan kadınlarda  38.2%  anormal
histereskopik bulgu  saptandı. H/S
yapılan primer inferil hastaların 60.24% ü(49/82) sekonder  inferil hastaların ise 73.68% inde (14/19)
herhangi bir histereskopik patolojik bulguya rastlanmadı. Endometrial polip her
iki grupta ensık  (9.8%( 10/102)) izlenen
anormal histereskopik bulgu idi. Uterin septum ise ikinci sıklıkta (8.8%
(9/102)) görülen anormal bulgu idi.

 İleri yaş  kadınlarda endometrial polıp ve septum, genç
yaş grupta endometrial polip ve inflamasyon ağırlıklı olarak izlendi.









Sonuç: Nedeni bilinmeyen infertilite  endikasyonu
ile  histereskopi  yapılan  
hastalarda,  yüksek oranda  uterin 
anormallik olduğu  tespit edildi. Bu
uterin patolojiler  uygulanacak
infertilite tedavilerinin başarısını düşürebileceğinden bu patolojilerin tanısı
önemlidir. Ofis histereskopi  hastanın
kolay tolere etmesi ve hasta için minimal risk taşımasından dolayı bu
hastalarda ideal ilk basamak tanı işlemi olarak kabul edilebilir.

References

  • 1. Practice Committee of tAmerican Society for Reproductive M. Definitions of infertility and recurrent pregnancy loss. Fertility and sterility. 2008;90(5 Suppl):S60. 2. Jahan S. Role of Laparoscopy in Infertility. BIRDEM Medical Journal. 2012;2(2):99-103. 3. Cândido dRF, Nogueira A, Ferriani R. Routine office hysteroscopy in the investigation of infertile couples before assisted reproduction. The Journal of reproductive medicine. 2005;50(7):501-6. 4. Crosignani P, Rubin B. Optimal use of infertility diagnostic tests and treatments. The ESHRE Capri Workshop Group. Human reproduction (Oxford, England). 2000;15(3):723-32. 5. Rowe P, Comhaire F, Hargreave T, Mellows H. WHO manual for the standardized investigation and diagnosis of the infertile couple. Press Syndicate of the University of Cambridge, Cambridge, 1993. 1993. 6. Prevedourakis C, Loutradis D, Kalianidis C, Makris N, Aravantinos D. Surgery: Hysterosalpingography and hysteroscopy in female infertility. Human Reproduction. 1994;9(12):2353-5. 7. Golan A, Eilat E, Ron-el R, Herman A, Soffer Y, Bukovsky I. Hysteroscopy is superior to hysterosalpingography in infertility investigation. Acta obstetricia et gynecologica Scandinavica. 1996;75(7):654-6. 8. Begum J, Samal S, Ghose S, Palai P, Samal R. Combined hysterolaparoscopy as an early option for initial evaluation of female infertility: a retrospective study of 135 patients. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2017;4(3):584-8. 9. Cholkeri-Singh A, Sasaki KJ. Hysteroscopy for infertile women: a review. Journal of minimally invasive gynecology. 2015;22(3):353-62. 10. Kilic Y, Bastu E, Ergun B. Validity and efficacy of office hysteroscopy before in vitro fertilization treatment. Archives of gynecology and obstetrics. 2013;287(3):577-81. 11. Demirol A, Gurgan T. Effect of treatment of intrauterine pathologies with office hysteroscopy in patients with recurrent IVF failure. Reproductive biomedicine online. 2004;8(5):590-4. 12. Campo R, Van Belle Y, Rombauts L, Brosens I, Gordts S. Office mini-hysteroscopy. Human Reproduction Update. 1999;5(1):73-81. 13. Pansky M, Feingold M, Sagi R, Herman A, Schneider D, Halperin R. Diagnostic hysteroscopy as a primary tool in a basic infertility workup. JSLS: Journal of the Society of Laparoendoscopic Surgeons. 2006;10(2):231. 14. Dicker D, Goldman JA, Ashkenazi J, Feldberg D, Dekel A. The value of hysteroscopy in elderly women prior to in vitro fertilization-embryo transfer (IVF-ET): a comparative study. Journal of in vitro Fertilization and Embryo transfer. 1990;7(5):267-70. 15. Shalev J, Meizner I, Bar-Hava I, Dicker D, Mashiach R, Ben-Rafael Z. Predictive value of transvaginal sonography performed before routine diagnostic hysteroscopy for evaluation of infertility. Fertility and sterility. 2000;73(2):412-7. 16. Pérez-Medina T, Bajo-Arenas J, Salazar F, Redondo T, Sanfrutos L, Alvarez P, et al. Endometrial polyps and their implication in the pregnancy rates of patients undergoing intrauterine insemination: a prospective, randomized study. Human Reproduction. 2005;20(6):1632-5. 17. Bosteels J, Kasius J, Weyers S, Broekmans FJ, Mol BWJ, D'Hooghe TM. Hysteroscopy for treating subfertility associated with suspected major uterine cavity abnormalities. The Cochrane Library. 2015. 18. Simón C, Martinez L, Pardo F, Tortajada M, Pellicer A. Müllerian defects in women with normal reproductive outcome. Fertility and sterility. 1991;56(6):1192-3. 19. Homer HA, Li T-C, Cooke ID. The septate uterus: a review of management and reproductive outcome. Fertility and sterility. 2000;73(1):1-14. 20. Zhang E, Zhang Y, Fang L, Li Q, Gu J. Combined hysterolaparoscopy for the diagnosis of female infertility: a retrospective study of 132 patients in china. Materia socio-medica. 2014;26(3):156.

Office Histeroscopy In Unexplained Infertile Women :The Most Common Abnormal Histeroscopic Findings

Year 2018, Volume: 49 Issue: 1, 140 - 143, 04.04.2018
https://doi.org/10.16948/zktipb.360699

Abstract

Objective: Cervical canal and uterine cavity are
evulated  by office  hysteroscopy (H/S) to determine the
intrauterine abnormal findings in 
unexplained primary and secondary infertile women .

Material and
method:
This study is a retrospective study that included 102 primary
and secondary infertile patients with unexplained infertility and who had not
previously had office hysteroscopy , applied to infertility and  IVF clinic of 
Harran University  Training and
Research  Hospital  between December 2016  and October 2017. Patients' age, infertility
type, duration of infertility, body mass index (BMI), complications and
hysteroscopic findings were recorded from patient files. Patients were divided
into 3 groups of 20-30, 31-35, 36-40 years infertile women.
Infertile
women between 20 and 30 years of age were accepted as younger age group and
other ages were  accepted as elder groups
. Office
hysteroscopy was performed by 3 experienced physicians.

Results: 81.37% (83/102) of patients were primary infertile and 18.63%
(19/102) were secondary infertile. In women with unexplained infertility,
abnormal hysteroscopic findings were found in 38.2%.  60.24% (49/82) of the primary infertile  patients and 73.68% (14/19) of the secondary
inferitile patients
who underwent hysteroscopy did not have any uterine  pathological findings. Endometrial
polyp was most common abnormal hysteroscopic finding in both groups (9.8%
(10/102)). Uterine septum was the second most common finding (8.8% (9/102)).
The incidence
of endothelial polyp and septum were high 
in advanced age women, and 
incidence of endometrial polyp and inflammation were high in young age
group.







Conclusion: In unexplained infertile patients who  underwent histeroscopy , high proportion of
uterin abnormalitıes were detected.

These abnormalities may impair the success of future ınfertility treatment
cycles  so diagnosis of these pathologies
ıs very important.
 Office hysteroscopy can be regarded as the ideal
first-line diagnostic procedure in these patients due to easy tolerating of the
patient and minimal risk for the patient.

References

  • 1. Practice Committee of tAmerican Society for Reproductive M. Definitions of infertility and recurrent pregnancy loss. Fertility and sterility. 2008;90(5 Suppl):S60. 2. Jahan S. Role of Laparoscopy in Infertility. BIRDEM Medical Journal. 2012;2(2):99-103. 3. Cândido dRF, Nogueira A, Ferriani R. Routine office hysteroscopy in the investigation of infertile couples before assisted reproduction. The Journal of reproductive medicine. 2005;50(7):501-6. 4. Crosignani P, Rubin B. Optimal use of infertility diagnostic tests and treatments. The ESHRE Capri Workshop Group. Human reproduction (Oxford, England). 2000;15(3):723-32. 5. Rowe P, Comhaire F, Hargreave T, Mellows H. WHO manual for the standardized investigation and diagnosis of the infertile couple. Press Syndicate of the University of Cambridge, Cambridge, 1993. 1993. 6. Prevedourakis C, Loutradis D, Kalianidis C, Makris N, Aravantinos D. Surgery: Hysterosalpingography and hysteroscopy in female infertility. Human Reproduction. 1994;9(12):2353-5. 7. Golan A, Eilat E, Ron-el R, Herman A, Soffer Y, Bukovsky I. Hysteroscopy is superior to hysterosalpingography in infertility investigation. Acta obstetricia et gynecologica Scandinavica. 1996;75(7):654-6. 8. Begum J, Samal S, Ghose S, Palai P, Samal R. Combined hysterolaparoscopy as an early option for initial evaluation of female infertility: a retrospective study of 135 patients. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2017;4(3):584-8. 9. Cholkeri-Singh A, Sasaki KJ. Hysteroscopy for infertile women: a review. Journal of minimally invasive gynecology. 2015;22(3):353-62. 10. Kilic Y, Bastu E, Ergun B. Validity and efficacy of office hysteroscopy before in vitro fertilization treatment. Archives of gynecology and obstetrics. 2013;287(3):577-81. 11. Demirol A, Gurgan T. Effect of treatment of intrauterine pathologies with office hysteroscopy in patients with recurrent IVF failure. Reproductive biomedicine online. 2004;8(5):590-4. 12. Campo R, Van Belle Y, Rombauts L, Brosens I, Gordts S. Office mini-hysteroscopy. Human Reproduction Update. 1999;5(1):73-81. 13. Pansky M, Feingold M, Sagi R, Herman A, Schneider D, Halperin R. Diagnostic hysteroscopy as a primary tool in a basic infertility workup. JSLS: Journal of the Society of Laparoendoscopic Surgeons. 2006;10(2):231. 14. Dicker D, Goldman JA, Ashkenazi J, Feldberg D, Dekel A. The value of hysteroscopy in elderly women prior to in vitro fertilization-embryo transfer (IVF-ET): a comparative study. Journal of in vitro Fertilization and Embryo transfer. 1990;7(5):267-70. 15. Shalev J, Meizner I, Bar-Hava I, Dicker D, Mashiach R, Ben-Rafael Z. Predictive value of transvaginal sonography performed before routine diagnostic hysteroscopy for evaluation of infertility. Fertility and sterility. 2000;73(2):412-7. 16. Pérez-Medina T, Bajo-Arenas J, Salazar F, Redondo T, Sanfrutos L, Alvarez P, et al. Endometrial polyps and their implication in the pregnancy rates of patients undergoing intrauterine insemination: a prospective, randomized study. Human Reproduction. 2005;20(6):1632-5. 17. Bosteels J, Kasius J, Weyers S, Broekmans FJ, Mol BWJ, D'Hooghe TM. Hysteroscopy for treating subfertility associated with suspected major uterine cavity abnormalities. The Cochrane Library. 2015. 18. Simón C, Martinez L, Pardo F, Tortajada M, Pellicer A. Müllerian defects in women with normal reproductive outcome. Fertility and sterility. 1991;56(6):1192-3. 19. Homer HA, Li T-C, Cooke ID. The septate uterus: a review of management and reproductive outcome. Fertility and sterility. 2000;73(1):1-14. 20. Zhang E, Zhang Y, Fang L, Li Q, Gu J. Combined hysterolaparoscopy for the diagnosis of female infertility: a retrospective study of 132 patients in china. Materia socio-medica. 2014;26(3):156.
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Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Original Research
Authors

Sibel Sak

Emin Taşdüzen This is me

Güler Çakmak This is me

Nurullah Peker

Talip Karaçor

Muhammet Erdal Sak

Publication Date April 4, 2018
Published in Issue Year 2018 Volume: 49 Issue: 1

Cite

APA Sak, S., Taşdüzen, E., Çakmak, G., Peker, N., et al. (2018). Açıklanamayan İnfertilitesi olan Kadınlarda Ofis Histereskopi:En Sık Saptanan Anormal Histereskopik Bulgular. Zeynep Kamil Tıp Bülteni, 49(1), 140-143. https://doi.org/10.16948/zktipb.360699
AMA Sak S, Taşdüzen E, Çakmak G, Peker N, Karaçor T, Sak ME. Açıklanamayan İnfertilitesi olan Kadınlarda Ofis Histereskopi:En Sık Saptanan Anormal Histereskopik Bulgular. Zeynep Kamil Tıp Bülteni. April 2018;49(1):140-143. doi:10.16948/zktipb.360699
Chicago Sak, Sibel, Emin Taşdüzen, Güler Çakmak, Nurullah Peker, Talip Karaçor, and Muhammet Erdal Sak. “Açıklanamayan İnfertilitesi Olan Kadınlarda Ofis Histereskopi:En Sık Saptanan Anormal Histereskopik Bulgular”. Zeynep Kamil Tıp Bülteni 49, no. 1 (April 2018): 140-43. https://doi.org/10.16948/zktipb.360699.
EndNote Sak S, Taşdüzen E, Çakmak G, Peker N, Karaçor T, Sak ME (April 1, 2018) Açıklanamayan İnfertilitesi olan Kadınlarda Ofis Histereskopi:En Sık Saptanan Anormal Histereskopik Bulgular. Zeynep Kamil Tıp Bülteni 49 1 140–143.
IEEE S. Sak, E. Taşdüzen, G. Çakmak, N. Peker, T. Karaçor, and M. E. Sak, “Açıklanamayan İnfertilitesi olan Kadınlarda Ofis Histereskopi:En Sık Saptanan Anormal Histereskopik Bulgular”, Zeynep Kamil Tıp Bülteni, vol. 49, no. 1, pp. 140–143, 2018, doi: 10.16948/zktipb.360699.
ISNAD Sak, Sibel et al. “Açıklanamayan İnfertilitesi Olan Kadınlarda Ofis Histereskopi:En Sık Saptanan Anormal Histereskopik Bulgular”. Zeynep Kamil Tıp Bülteni 49/1 (April 2018), 140-143. https://doi.org/10.16948/zktipb.360699.
JAMA Sak S, Taşdüzen E, Çakmak G, Peker N, Karaçor T, Sak ME. Açıklanamayan İnfertilitesi olan Kadınlarda Ofis Histereskopi:En Sık Saptanan Anormal Histereskopik Bulgular. Zeynep Kamil Tıp Bülteni. 2018;49:140–143.
MLA Sak, Sibel et al. “Açıklanamayan İnfertilitesi Olan Kadınlarda Ofis Histereskopi:En Sık Saptanan Anormal Histereskopik Bulgular”. Zeynep Kamil Tıp Bülteni, vol. 49, no. 1, 2018, pp. 140-3, doi:10.16948/zktipb.360699.
Vancouver Sak S, Taşdüzen E, Çakmak G, Peker N, Karaçor T, Sak ME. Açıklanamayan İnfertilitesi olan Kadınlarda Ofis Histereskopi:En Sık Saptanan Anormal Histereskopik Bulgular. Zeynep Kamil Tıp Bülteni. 2018;49(1):140-3.