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HyCoSy as Primary Screening Test for Infertile Women

HyCoSy as Primary Screening Test for Infertile Women Dr. Archna Mohan , MBBS, MS, MRCOG (UK) Sultan Qaboos Hospital, Ministry of Health, Oman. Objectives. Data Collection. Results contd. Conclusions. O.T. & Minor procedure registers. Radiology Department. Patient’s record.

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HyCoSy as Primary Screening Test for Infertile Women

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  1. HyCoSy as Primary Screening Test for Infertile Women Dr. ArchnaMohan, MBBS, MS, MRCOG (UK)Sultan Qaboos Hospital, Ministry of Health, Oman Objectives Data Collection Results contd Conclusions • O.T. & Minor procedure registers. • Radiology Department. • Patient’s record. • Patients were interviewed over the phone and personally for their experience in relation to pain, embarrassment and satisfaction. The main objective is to ascertain the suitability of HyCoSy as a primary method of screening test for tubal patency in sub-fertile women. In recent years , HyCoSy has increasingly been used in preference to other methods and has come up as first line of investigating tool due to convenience, accuracy and safety. • HyCoSy • Provides a low risk • OPD procedure • Comparable accuracy to HSG • Without associated risk of radiation • Has lesser cost and cost effective • Requires Less number of staff • It can demonstrate uterine cavity and ovaries • HSG • Has been found to be much more painful compared to HyCoSy • With lesser privacy & more embarrassment • Incurs radiation burden to the patient and operator both • Dye Laparoscopy • Requires G.A • Does not show the shape of the uterine cavity • It exposes the patients to high risk of anaesthesia & surgery • The risk is higher in obese & morbidly obese women (>50% had BMI>35 and 09% were morbidly obese i.e. BMI >40 kg./m2) Evaluation in terms of • Acceptability to the patient • Availability of Skilled operator • Availability of the equipment • Diagnostic accuracy • Evaluation of risks and benefits • Possible adverse effects • The cost compared Methods • Retrospective study • January 2008 till December 2011 ( 3 Yrs.) • Comparing various tubal patency tests – HSG, HyCoSy and Dye-Laparoscopy • HyCoSydone by using saline & air, with trans-vaginal ultrasound and Color Doppler. Results Total number of women who required various tubal patency tests = 456 * Cost of Laparoscopic procedure is much higher Recommendation • HyCoSyis an ideal primary screening test for tubal patency • It is recommended to increase the use of HyCoSy • Use of Colour Doppler increases accuracy, even with saline, and saves cost • It needs trained personal • To have more trained Obstetricians /Radiologists

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