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Role of saline infusion sonography in uterine evaluation before frozen embryo transfer cycle
Puja S Gera1, Michael C Allemand, Laura L Tatpati
1Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Objective:
To determine the role of saline infusion sonography (SIS) in uterine evaluation before a frozen embryo transfer (FET) cycle.
Design:
Retrospective cohort analysis.
Setting:
University hospital.
Patient(S):
Thirty-six patients who had uterine evaluation by SIS before FET cycle.
Intervention(S):
The SIS was performed in the follicular phase of the menstrual cycle before the actual FET cycle.
Main Outcome Measure(S):
The SIS findings, clinical pregnancy rate (PR), ongoing PR, and correlation between positive SIS findings with and without subsequent treatment and pregnancy outcome.
Result(S):
Positive SIS findings were found in 11/36 patients (30.5%), which included uterine septum (9.0%), endometrial polyp (45.4%), intramural fibroid with normal cavity (9.0%), cystic endometrial changes (9.0%), cervical stenosis (18.1%), and calcification with normal cavity (9.0%). The overall clinical PR in all groups was 51.4%, with an ongoing PR of 45.7%. Patients with positive SIS finding who underwent subsequent hysteroscopic correction (7/11) had a clinical PR of 85.7% as compared to 54.1% in patients with normal uterine cavity (24/35). Patients with positive SIS findings and no operative hysteroscopy (4/11) had a clinical PR of 50% and pregnancy loss rate of 100%.
Conclusion(S):
Obtaining an SIS before the FET cycle can be helpful in the detection of uterine abnormalities. If time since uterine evaluation has been more than 1-2 years, performing an SIS is recommended as subsequent correction of the anomalies may improve FET outcome.
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