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Patient and provider satisfaction with saline ultrasound versus office hysteroscopy for uterine cavity evaluation prior to in vitro fertilization: a randomized controlled trial

  • Assisted Reproduction Technologies
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Abstract

Purpose

To compare patient and provider satisfaction with saline ultrasound (SIS) versus office hysteroscopy for cavity evaluation prior to in vitro fertilization (IVF) and to assess the capability of hysteroscopy to manage pathology at time of diagnosis to reduce delays and supernumerary procedures.

Methods

This was a randomized, controlled trial in a university fertility clinic. One hundred enrolled subjects undergoing routine uterine cavity evaluation prior to planned embryo transfer were randomized to SIS or office hysteroscopy without anesthesia. Subjects and providers completed surveys about their experience. Subjects with findings on SIS had a hysteroscopy performed or scheduled for further evaluation. Those with hysteroscopy findings had management attempted within the same procedure.

Results

Overall patient satisfaction was high and did not differ between groups, while providers indicated that hysteroscopy provided a better cavity evaluation. There was no difference in time to complete procedures between groups. Pain score on a ten-scale was slightly higher in the hysteroscopy group compared to the SIS group (3.38 ± 1.85 vs. 2.44 ± 1.64, p < 0.01), but this did not impact satisfaction scores. Although pathology was found in a similar rate (22% vs. 36% for SIS and HSC groups, respectively), those in the SIS group all required secondary procedures, while only 1/17 did in the HSC group (p < 0.01).

Conclusion

Although the hysteroscopy group exhibited slightly higher pain scores, overall patient and provider satisfaction was high and similar between groups. There were significantly fewer secondary procedures and delays in the hysteroscopy group. Hysteroscopy is a reasonable first line screening tool for patients requiring cavity evaluation.

Trial registration

ClinicalTrials.gov, NCT04415489

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Data availability

Data are available upon request with appropriate institutional ethics approval.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA

    Sarah Moustafa & Linnea Goodman

  2. Gillings School of Public Health, University of North Carolina School, Chapel Hill, NC, USA

    Emma Rosen

Authors
  1. Sarah Moustafa
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  2. Emma Rosen
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  3. Linnea Goodman
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Correspondence to Sarah Moustafa.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

This study was prospectively approved by the University of North Carolina Institutional Review Board.

Consent to participate

All patients signed informed consents to participate in this trial.

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All patients and providers consented to publication of the results of this trial.

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Supplementary information

ESM 1

Online Resource 1 Consort flow diagram depicting subject enrollment and follow up. (PNG 290 kb).

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Moustafa, S., Rosen, E. & Goodman, L. Patient and provider satisfaction with saline ultrasound versus office hysteroscopy for uterine cavity evaluation prior to in vitro fertilization: a randomized controlled trial. J Assist Reprod Genet 38, 627–634 (2021). https://doi.org/10.1007/s10815-021-02065-9

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  • DOI: https://doi.org/10.1007/s10815-021-02065-9

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