Effectiveness of misoprostol for office hysteroscopy without anesthesia in infertile patients

To evaluate and compare the effectiveness of oral and vaginal misoprostol versus placebo to facilitate office hysteroscopy without anesthesia during infertile diagnostic evaluation.

Randomized, prospective trial.

Patients scheduled for diagnostic office hysteroscopy at a university hospital.

Seventy-five infertile patients scheduled for diagnostic office hysteroscopy.

Patients were divided into three groups: group A received oral misoprostol 600 μg; group B, vaginal misoprostol 400 μg; and group C, oral placebo.

Pain, evaluated by visual analogue scale, and surgical time were recorded and compared. Statistical analysis was done using Student's t-test.

Pain was low in the vaginal misoprostol group. Mean visual analogue scale in the oral misoprostol group was 6.04 ± 1.5; in the vaginal misoprostol group 2.85 ± 1.2; and in the placebo group 7.50 ± 1.5. Procedural time for office hysteroscopy was shorter in the vaginal misoprostol group (2.7 ± 1.0 minutes) compared with group A (5.5 ± 1.1 minutes) and group C (6.3 ± 3.8 minutes).

Vaginal misoprostol, 400 μg, administered the day before office hysteroscopy considerably reduces pain and the time needed for hysteroscopy. This simple strategy may facilitate office hysteroscopy during an infertility work-up.