Propofol vs. thiopental NA; pregnancy outcome and postoperative nausea and vomiting [PONV] in art cycle

The aim of this study was to compare the side effects, fertilization rate and pregnancy rate [PR] and duration of recovery between Propofol and Thiopental Na after ICSI-vaginal retrieval of oocyte in ART cycle. This study was a prospective, randomized clinical trial. Ninety eight ASA [American Society of Anesthesiologist] physical status I and II women participating in an intracytoplasmic sperm injection [ICSI] program were assessed. All of the patients underwent general anesthesia induction with Propofol and Thiopental Na. The first group [49 cycles] received 2-2.5mg/kg of Propofol, and the second group [49 cycles] received 5mg/kg Thiopental during transvaginal oocyte retrieval. An informed consent form was obtained for each patient's treatment. Variables under study included: female age, cause and duration of infertility postoperative nausea and vomiting [PONV], heamodynamic changes, mean number of oocyte retrieved, oocyte metaphase II, embryo cleaved, embryo transferred, embryo quality and pregnancy rate [PR] and duration recovery. Statistical analysis was carried out by using SPSS. 10 software and statistical test of T-test and chi-square. The PR in Propofol group was 18 [36.7%] and in Thiopental Na group was 19 [38.8%] with no significant differences the mean duration of infertility and weight weren't statistically significant. The mean number of oocyte retrieved [metaphase II], embryo cleaved, embryo transferred and embryo quality weren't significant between the two groups. The incidence of nausea in Propofol group in comparison with Thiopental Na group was lower with significant differences. The incidence of vomiting between two groups was statistically significant [46.9% vs. 28.6% respectively] [p<0.05] between two groups Duration of recovery in Propofol group was 15 +/- 3 min and in Thiopental Na group was 25 +/- 5 min that was statistically significant [P<0.05]. Propofol offered lowerincidence of post operative nausea and vomiting and a quick recovery from anesthesia without any adverse effect on pregnancy outcome. These findings showed that Propofol was a good alternative for Thiopental Na in short time operation, like ICSI -vaginal retrieval of oocytes

Vaginal sonography and hysteroscopy; comparison in infertility patients

Hysteroscopy is a valuable diagnostic and therapeutic modality in the management of infertility. To evaluate the consistency of hysteroscopy based on a histopathological report from endometrial specimens for intrauterine disorders. This is a cross-sectional study. The study included 115 infertile patients. All were admitted for investigation of infertile women before assisted reproduction in Mehr infertility institute between 2006 and 2007 hysteroscopy, and histological evaluation of endometrial biopsy performed.We compared the efficacy of hysteroscopy in the diagnosis of benign intrauterine pathology in infertile women in whom the diagnosis was confirmed by histological studies. The women had a complete evaluation with preoperative hysteroscopy, and histological analysis of uterine cavity specimens. Sensitivity and specificity, predictive were calculated for hysteroscopy considering the histological study as 100%. Sensitivity and specificity of sonography in diagnosing the polyp were stated 81% and 64% respectively. Sensitivity and specificity of hysteroscopy showed of polyps revealed 85% and 84% respectively. The results indicated that sensitivity and specificity of sonography in diagnosing the myoma were 25% and 98% respectively. Sensitivity and specificity of hysteroscopy in diagnosing the myoma were expressed 50% and 93% respectively. Hysteroscopy is a safe and rapid direct visualisation of the uterine cavity. We believe it should be replaced by the diagnostic hysteroscopy as a first line infertility investigation