Izhar Rubina, Husain Samia, Tahir Suhaima, Husain Sonia
Department of Gynaecology and Obstetrics ,, Abbasi Shaheed Hospital & Karachi Medical and Dental College and Aziz Medical Center , Karachi , Pakistan.
Aziz Medical Center , Karachi , Pakistan.
J Ultrason. 2019;19(77):113-119. doi: 10.15557/JoU.2019.0016. Epub 2019 Jun 28.
To assess the effect of removal of unsuspected polyps as delineated on saline sonography on the clinical pregnancy rate in women with unexplained infertility. A prospective case control study was being conducted from 1st October 2016 to 30 September 2018 at Aziz Medical Centre, Karachi. Women diagnosed with unexplained infertility and unsuspected polyps revealed on saline sonography were included as cases (Group A). They were offered removal of polyps under ultrasound guidance and general anesthesia. Saline sonography was repeated at the time to ensure complete removal (Izhar's Modification). Those with unsuspected polyps on saline sonography, but who refused the intervention, were classified as controls (Group B). Both groups were followed for one year. The primary outcome measure was women who had clinical pregnancy i.e. fetal heartbeat present on transvaginal scan during the follow up period. During the study period, out of 92 cases, 37 (40.2%) conceived and out of 92 controls, 10 (10.9%) conceived, which proved that polypectomy increased the chances of conception four-fold ( <0.001). The mean time to conception was also significantly lower for cases than controls (9.26 ± 3.928 months 11.33 ± 2.07 months, <0.001). The cumulative pregnancy rate was significantly higher in the polypectomy group (log-rank test, <0.001). The duration of infertility ( = 0.007), position of polyp ( = 0.049) and polypectomy ( <0.001) influenced pregnancy rate. Our study shows the beneficial effect of removal of polyps. Women are four times more likely to conceive spontaneously after polypectomy. To assess the effect of removal of unsuspected polyps as delineated on saline sonography on the clinical pregnancy rate in women with unexplained infertility. A prospective case control study was being conducted from 1st October 2016 to 30 September 2018 at Aziz Medical Centre, Karachi. Women diagnosed with unexplained infertility and unsuspected polyps revealed on saline sonography were included as cases (Group A). They were offered removal of polyps under ultrasound guidance and general anesthesia. Saline sonography was repeated at the time to ensure complete removal (Izhar’s Modification). Those with unsuspected polyps on saline sonography, but who refused the intervention, were classified as controls (Group B). Both groups were followed for one year. The primary outcome measure was women who had clinical pregnancy i.e. fetal heartbeat present on transvaginal scan during the follow up period. During the study period, out of 92 cases, 37 (40.2%) conceived and out of 92 controls, 10 (10.9%) conceived, which proved that polypectomy increased the chances of conception four-fold ( <0.001). The mean time to conception was also significantly lower for cases than controls (9.26 ± 3.928 months 11.33 ± 2.07 months, <0.001). The cumulative pregnancy rate was significantly higher in the polypectomy group (log-rank test, <0.001). The duration of infertility ( = 0.007), position of polyp ( = 0.049) and polypectomy ( <0.001) influenced pregnancy rate. Our study shows the beneficial effect of removal of polyps. Women are four times more likely to conceive spontaneously after polypectomy.
评估经盐水超声检查发现的隐匿性息肉切除对不明原因不孕症女性临床妊娠率的影响。2016年10月1日至2018年9月30日在卡拉奇的阿齐兹医疗中心进行了一项前瞻性病例对照研究。经盐水超声检查发现患有不明原因不孕症且有隐匿性息肉的女性被纳入病例组（A组）。她们在超声引导和全身麻醉下接受息肉切除术。当时重复进行盐水超声检查以确保完全切除（伊扎尔改良法）。经盐水超声检查有隐匿性息肉但拒绝干预的女性被归类为对照组（B组）。两组均随访一年。主要观察指标是在随访期间经阴道扫描发现有胎儿心跳即临床妊娠的女性。在研究期间，92例病例中有37例（40.2%）怀孕，92例对照组中有10例（10.9%）怀孕，这证明息肉切除术使受孕几率提高了四倍（<0.001）。病例组的平均受孕时间也显著低于对照组（9.26±3.928个月对11.33±2.07个月，<0.001）。息肉切除组的累积妊娠率显著更高（对数秩检验，<0.001）。不孕持续时间（=0.007）、息肉位置（=0.049）和息肉切除术（<0.001）影响妊娠率。我们的研究显示了息肉切除的有益效果。息肉切除术后女性自然受孕的可能性增加四倍。评估经盐水超声检查发现的隐匿性息肉切除对不明原因不孕症女性临床妊娠率的影响。2016年10月1日至2018年9月30日在卡拉奇的阿齐兹医疗中心进行了一项前瞻性病例对照研究。经盐水超声检查发现患有不明原因不孕症且有隐匿性息肉的女性被纳入病例组（A组）。她们在超声引导和全身麻醉下接受息肉切除术。当时重复进行盐水超声检查以确保完全切除（伊扎尔改良法）。经盐水超声检查有隐匿性息肉但拒绝干预的女性被归类为对照组（B组）。两组均随访一年。主要观察指标是在随访期间经阴道扫描发现有胎儿心跳即临床妊娠的女性。在研究期间，92例病例中有37例（40.2%）怀孕，92例对照组中有10例（10.9%）怀孕，这证明息肉切除术使受孕几率提高了四倍（<0.001）。病例组的平均受孕时间也显著低于对照组（9.26±3.928个月对11.33±2.07个月，<0.001）。息肉切除组的累积妊娠率显著更高（对数秩检验，<0.001）。不孕持续时间（=0.007）、息肉位置（=0.049）和息肉切除术（<0.001）影响妊娠率。我们的研究显示了息肉切除的有益效果。息肉切除术后女性自然受孕的可能性增加四倍。
