Objectives: To evaluate the benefit of modified hydrotubation with dexamethasone and antibiotics after hysterosalpingography in improving pregnancy rates in women with infertility issue. Methods: This retrospective study conducted at County Emergency Clinical Hospital Oradea, Bihor, Romania, between January 2017 and December 2019. One hundred twenty infertile females were investigated, as part of their evaluation, Hysterosalpingography was performed. After the investigation 97 patients had taken utero-tubal instillations with (Ceftriaxone 1 gr. [Cefort] and 4 mg of Dexamethasone, Lidocaine 1% 10 ml, and a Sodium chloride 0.9% 10 ml), and 23 patients were included in the control group which didn’t receive utero-tubal instillations. Number of obtained pregnancies by natural way over the next year was compared in the two groups. Results: From all participants in this study, 30 women became pregnant during the study. In addition, 29 out of 30 pregnant women had taken hydrotubation procedure. The significant statistical difference was observed between the groups p=0.011 (p<0.05), and the odd ratio was less than one (OR=9.3, 95%, CI:1,207 to 72.926). We also found an indirect correlation between abortion in the past and the pregnancy ratio (r=-0.21). Conclusion: The results of the study demonstrated that the application of modified hydrotubation with the administration of dexamethasone and antibiotics in patients who had at least one patent fallopian tubes, can increase the chance of fertility. doi: https://doi.org/10.12669/pjms.38.5.5432 How to cite this:Amin-Florin EK, Florin S. Improvement of fertility outcomes using dexamethasone / antibiotic adjuvant therapy following hysterosalpingography in infertile females: A randomised trial. Pak J Med Sci. 2022;38(5):---------. doi: https://doi.org/10.12669/pjms.38.5.5432 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Anomalies of the fallopian tubes represent one of the most significant elements that might contribute to reproductive issues. They can be inherited or acquired; they are among the most important problems of the profession. Although there is much discussion regarding which therapies for each tubal disease are the most effective and result in the best long-term reproductive outcomes. During the evaluation of an infertile couple, certain anomalies of the fallopian tubes are frequently discovered. These abnormalities were thought, for a long time, to not have an influence on fertility; however, in recent years, researchers have discovered that they seem to play a crucial role in fertility problems. Couples in industrialized countries are postponing childbearing, which raises the risk of women developing tubal diseases before they are ready to become pregnant. These disorders may have a negative impact on a woman's ability to get pregnant. The goals of this study are to conduct research to gain a deeper understanding of the recent advancements that have been made in the field of tubal diseases and to carry out an evaluation of the medical conducts that have the best fertility outcomes. We searched both Medline and PubMed, paying special attention to the most relevant articles that have been added to either database over the course of the last six years.
Introduction and objectives This research undertakes a comprehensive evaluation of demographic information and medical antecedents, in addition to intraoperative observations, for patients diagnosed with tubal obstruction. Furthermore, we delineate the therapeutic procedures implemented to achieve bilateral tubal patency. The overarching objective of this study is to ascertain the efficacy of the aforementioned therapeutic procedures and to establish an optimal timeframe before the necessity for exogenous intervention becomes apparent. Material and methods This study conducted a retrospective analysis of patients diagnosed with infertility due to tubal obstruction at the Oradea County Clinical Hospital, spanning a six-year period from 2017 through 2022. We evaluated numerous factors, including demographic data of the patients, intraoperative observations, and the exact site of the obstruction within the fallopian tubes. Additionally, we monitored patients post-procedure to assess their potential for fertility following the intervention. Our study involved a comprehensive examination of 360 patients in total. The primary objectives of our research were to provide clinicians with significant insights regarding the likelihood of spontaneous conception subsequent to surgical interventions and to propose guidelines on establishing an adequate waiting period prior to recommending other interventions. We employed a mix of descriptive and inferential statistical methods to analyze the data amassed. Results This study encompassed an initial patient population of 360 included in the study following specific exclusion criteria; the remaining 218 patients constituted the study cohort. The mean±SD age of the patients was 27.9±4.4. Out of the entire cohort, 47 patients presented with minimal adhesions, while 117 patients exhibited blockages in one fallopian tube. A total of 54 patients were diagnosed with bilateral tubal defects. Post-intervention, patients were monitored and it was noted that 63 patients achieved pregnancy. The correlation analysis indicated the significant impact of tubal defect characteristics and patient age on fertility outcomes. The most favorable fertility outcomes were observed to be influenced by factors such as patient age and blockage location, while a higher body mass index (BMI) was found to exert a negative impact on fertility. Temporal analysis revealed that 52 patients conceived within the initial six months post-intervention, whereas only 11 patients became pregnant in the subsequent months. Conclusions Our research indicates that age, parity, and tubal damage severity predict tubal intervention success. Fimbriolysis was the most successful, while outcomes for salpingotomy varied. Conception significantly declined 12 months post-intervention, suggesting this is a reasonable waiting limit for a successful pregnancy.
It is estimated that about 10-15% of couples of fertile ages suffer from infertility worldwide, in over a third cases of infertility are caused by female infertility, but most often the gynecologist is the first provider of medical services that the couple reaches. The studies in this field are multiple and with a very accelerated rhythm, this study aimed to make a review of the most relevant new studies in the field of infertility.
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