misoprostol and Infertility--Female

Topics: Administration, Intravaginal; Administration, Oral; Adult; Cervix Uteri; Drug Administration Schedule; Female; Humans; Hysteroscopy; Infertility, Female; Misoprostol; Oxytocics; Parity

To evaluate and compare the effectiveness of oral and vaginal misoprostol versus placebo to facilitate office hysteroscopy without anesthesia during infertile diagnostic evaluation.. Randomized, prospective trial.. Patients scheduled for diagnostic office hysteroscopy at a university hospital.. Seventy-five infertile patients scheduled for diagnostic office hysteroscopy.. Patients were divided into three groups: group A received oral misoprostol 600 μg; group B, vaginal misoprostol 400 μg; and group C, oral placebo.. Pain, evaluated by visual analogue scale, and surgical time were recorded and compared. Statistical analysis was done using Student's t-test.. Pain was low in the vaginal misoprostol group. Mean visual analogue scale in the oral misoprostol group was 6.04 ± 1.5; in the vaginal misoprostol group 2.85 ± 1.2; and in the placebo group 7.50 ± 1.5. Procedural time for office hysteroscopy was shorter in the vaginal misoprostol group (2.7 ± 1.0 minutes) compared with group A (5.5 ± 1.1 minutes) and group C (6.3 ± 3.8 minutes).. Vaginal misoprostol, 400 μg, administered the day before office hysteroscopy considerably reduces pain and the time needed for hysteroscopy. This simple strategy may facilitate office hysteroscopy during an infertility work-up.

Topics: Administration, Intravaginal; Adult; Ambulatory Surgical Procedures; Anesthesia; Female; Humans; Hysteroscopy; Infertility, Female; Middle Aged; Misoprostol; Oxytocics; Pain Measurement; Pain, Postoperative; Placebos; Treatment Outcome; Young Adult

To evaluate the efficacy and safety of vaginal misoprostol for cervical priming before diagnostic outpatient hysteroscopy (OH) without anesthesia.. Double-blind randomized controlled trial.. University teaching hospital.. One hundred fifty patients requiring diagnostic OH for investigation of infertility or abnormal uterine bleeding in the reproductive age.. Patients were randomly allocated into two equal groups (n = 75). In group I, 200 μg misoprostol was inserted into the posterior vaginal fornix 3 hours before OH; in group II (control), vaginal examination was performed without misoprostol administration. A rigid 30° 4-mm hysteroscope was used in the vaginoscopic technique.. Ease of cervical entry (Likert scale), procedural time, patient acceptability (Likert scale), and pain scoring (visual analog scale).. Vaginal misoprostol significantly facilitated the procedure; cervical entry was easier, procedural time was shorter, patient acceptability was higher, and pain scoring was lower in group I compared with group II. Side effects of misoprostol were infrequent, minor, and transient. No complications were reported.. The regimen of 200 μg vaginal misoprostol administered 3 hours before diagnostic OH is a simple, effective, and safe method of cervical priming to facilitate the procedure without anesthesia.

Topics: Administration, Intravaginal; Adult; Ambulatory Care; Cervix Uteri; Double-Blind Method; Female; Humans; Hysteroscopy; Infertility, Female; Misoprostol; Pain Measurement; Young Adult

The goal of this study was to evaluate the effect ofmisoprostol on pregnancy rate after intrauterine insemination. This randomized double blind clinical trial study was performed on 66 (33 cases and 33 controls) infertile women who referred to infertility center of Imam Khomeini Hospital Sari, Iran for intrauterine insemination during 2006-2007. The two groups were matched for age, infertility causes and BMI. After intrauterine insemination, 200 mcg misoprostol was placed in posterior fornix of case group and a similar placebo tablet in control group. Chemical and clinical pregnancies and complications were recorded. Results were analyzed by means of SPSS 11 software, paired t-test and student t-test. The p-values of less than 0.05 were considered to be statistically significant. Chemical pregnancy (positive BHCG) occurred in 6 patients (18.2%) in each group. Clinical pregnancy occurred in 5 patients (15.15%) in case and 6 patients (18.2%) in controls. There were no significant statistical differences in complications between the two groups. Vaginal misoprostol after intrauterine insemination does not improve pregnancy rate.

Topics: Abortifacient Agents, Nonsteroidal; Administration, Intravaginal; Adult; Animals; Double-Blind Method; Female; Humans; Infertility, Female; Insemination, Artificial; Male; Misoprostol; Pregnancy; Pregnancy Rate; Spermatozoa; Vagina; Young Adult

We aimed to compare efficacy of intravaginal misoprostol versus endocervical laminaria tents prior to operative hysteroscopy in selected cases.. A total of 144 patients with diagnosed intrauterine lesions scheduled for operative hysteroscopy were randomly allocated to two groups according to method of cervical priming prior to the procedure. Misoprostol 200 microg was inserted into the posterior fornix of the vagina for patients in group A (n=72), while laminaria tents were inserted intracervically in group B patients (n=72).. Both methods were effective for cervical dilatation with a mean cervical diameter of 7.5+/-1.2 and 7.6+/-1.2 mm respectively. There was no significant difference in the mean cervical diameter or the time required for cervical dilatation (51.6 versus 51.4 s respectively). In contrast, there was a significant difference between the groups with respect to the insertion difficulty and in doctors' and patients' assessments of the procedure.. Both misoprostol and laminaria were equally effective in inducing proper cervical priming prior to operative hysteroscopy with minimal time of cervical dilatation. Nevertheless, misoprostol may be superior due to easy application, reduced cost, and patient convenience and acceptability.

Topics: Adult; Cervix Uteri; Female; Humans; Hysteroscopy; Infertility, Female; Laminaria; Middle Aged; Misoprostol; Oxytocics; Preoperative Care; Treatment Outcome

To examine whether misoprostol treatment for first trimester missed abortion affects future fertility.. In a historical prospective approach, we analyzed our database for patients treated with misoprostol. All eligible patients underwent an interview according to a questionnaire, which includes their demographic characteristics, obstetric, gynecologic and infertility history. They were asked about the side effects, intention and subsequent ability to conceive. Their future pregnancy rates were calculated and compared to the acceptable figures in the literature.. The infertility rates among our patients were similar to those reported in the general population. Pregnancy rates 2 years after treatment were similar to the previously published reports, except for lower rates during the first three months post-treatment. Although no between-group differences were observed in the subsequent pregnancy rates, 2 years following misoprostol treatment in ≤35 versus >35 years old patients, primi- versus multigravida and nulli- versus parous women, higher pregnancy rates were observed in patients ≤35 versus >35 years old, primi- versus multigravida and nulli- versus, parous, during the first 3 months following misoprostol treatment.. Misoprostol treatment, for women with first trimester missed abortion and favorable reproductive history, is an acceptable treatment with no detrimental effect on future fertility.

Topics: Abortifacient Agents, Nonsteroidal; Abortion, Spontaneous; Female; Humans; Infertility, Female; Misoprostol; Pregnancy; Prospective Studies; Retrospective Studies; Surveys and Questionnaires; Ultrasonography