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A simplified ultrasound based infertility investigation protocol and its implications for patient management
A Strandell1, T Bourne, C Bergh
1Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Göteborg, Sweden.
Purpose:
To evaluate whether a simplified infertility investigation protocol, focusing on the use of hysterocontrast sonography (HyCoSy), one blood test, and a semen analysis, would be sufficient as an initial screening test to select couples for specific treatment.
Methods:
The infertile couples underwent gynaecological examination, cervical sampling for cytology and Chlamydia trachomatis culture, B-mode transvaginal ultrasonography and basic hormonal analyses followed by a HyCoSy, and a semen analysis. A preliminary diagnosis was made for all patients. A management plan for treatment was suggested when possible; otherwise further examinations were recommended. The data were stored for later analysis and the routine investigation protocol was then adhered to and a final diagnosis and treatment were decided upon.
Results:
Agreement between the diagnosis based on HyCoSy and our routine protocol was present in 74% of cases (N = 73). In 13% (N = 13) there was partial agreement. In 36% the HyCoSy based protocol was considered sufficient to suggest treatment.
Conclusions:
A simplified approach may lead to a significant reduction in both the time and cost of investigating an infertile couple.