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<p>
<bold>Aim:</bold> To assess the effect of ultrasound-guided cervical dilation on clinical pregnancy rates in women with cervical stenosis. <bold>Methods:</bold> A prospective case control study was conducted in women with unexplained infertility. These women underwent saline infusion sonography and were suspected of having cervical stenosis if a 7 French Foley’s catheter could not be introduced into the cervical canal. Women with suspected stenosis who agreed to undergo ultrasound guided dilation were included as cases. Those with suspected stenosis who refused dilation were used as controls. Both groups were followed for one year. The primary outcome measure was women who had clinical pregnancy i.e. fetal heart beat present on transvaginal scan during the follow up period. <bold>Results:</bold> During the study period, 1097 women who underwent SIS were included. A total of 117 (10.7%) patients had cervical stenosis. No statistically significant difference was there in both groups in terms of mean age (<italic>p</italic> = 0.617), mean body mass index (<italic>p</italic> = 0.598), duration of infertility (<italic>p</italic> = 0.588) and type of infertility (<italic>p</italic> = 0.167). However, both groups were significantly different in terms of history for risk factors i.e. endometriosis (<italic>p</italic> &lt;0.001), prior surgery (<italic>p</italic> &lt;0.001), polyps (<italic>p</italic> = 0.004) and pelvic inflammatory disease (<italic>p</italic> = 0.001). Eighty-nine women agreed to have dilation and were used as cases and 28 women refused and were used as controls. Of the cases, 70.45% conceived as compared to 18.5% of controls. The mean time to conception in months was also significantly lower in cases (8.10 ± 3.43 vs. 11.39 ± 1.97, <italic>p</italic> &lt;0.001). <bold>Conclusions:</bold> Our study shows that ultrasound-guided cervical dilation in women with cervical stenosis can lead to improved conception rates.</p>
</abstract>

Aim: To assess the effect of ultrasound-guided cervical dilation on clinical pregnancy rates in women with cervical stenosis. Methods: A prospective case control study was conducted in women with unexplained infertility. These women underwent saline infusion sonography and were suspected of having cervical stenosis if a 7 French Foley’s catheter could not be introduced into the cervical canal. Women with suspected stenosis who agreed to undergo ultrasound guided dilation were included as cases. Those with suspected stenosis who refused dilation were used as controls. Both groups were followed for one year. The primary outcome measure was women who had clinical pregnancy i.e. fetal heart beat present on transvaginal scan during the follow up period. Results: During the study period, 1097 women who underwent SIS were included. A total of 117 (10.7%) patients had cervical stenosis. No statistically significant difference was there in both groups in terms of mean age (p = 0.617), mean body mass index (p = 0.598), duration of infertility (p = 0.588) and type of infertility (p = 0.167). However, both groups were significantly different in terms of history for risk factors i.e. endometriosis (p <0.001), prior surgery (p <0.001), polyps (p = 0.004) and pelvic inflammatory disease (p = 0.001). Eighty-nine women agreed to have dilation and were used as cases and 28 women refused and were used as controls. Of the cases, 70.45% conceived as compared to 18.5% of controls. The mean time to conception in months was also significantly lower in cases (8.10 ± 3.43 vs. 11.39 ± 1.97, p <0.001). Conclusions: Our study shows that ultrasound-guided cervical dilation in women with cervical stenosis can lead to improved conception rates.

Cervical stenosis and pregnancy rate after ultrasound guided cervical dilation in women undergoing saline infusion sonography

Journal of Ultrasonography

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Aim: To assess the effect of ultrasound-guided cervical dilation on clinical pregnancy rates in women with cervical stenosis. Methods: A prospective case...

	Mean +/- Standard deviation or n (%)
Age in years	28.99 ± 5.40
BMI	27.57 ± 4.39
Duration of infertility in years	3.94 ± 1.59
Type of infertility
Primary	637 (58.1%)
Secondary	460 (41.9%)
Stenosis
Yes	117 (10.7%)
No	980 (89.3%)
Dilation
Yes	89 (8.1%)
No	1008 (91.9%)

	Stenosis		p-value
	Yes
	Dilation
	Yes	No
	Mean ± SD or count n (%)	Mean ± SD or count n (%)
Pregnancy
Yes	62 (70.45%)	5 (18.5%)	<0.001*
No	26 (29.54%)	22 (81.48%)
Time to pregnancy	8.10 ± 3.43	11.39 ±1.97	<0.001*

Characteristics	Stenosis		p-value
	Yes	No
	Mean ± SD or count n (%)	Mean ± SD or count n (%)
Age in years	28.75 ± 5.08	29.02 ± 5.44	0.617
BMI	27.36 ± 4.48	27.59 ± 4.38	0.598
Duration of infertility in years	4.03 ± 1.68	3.93 ± 1.58	0.588
Type of infertility	70 (59.8%)	567 (57.9%)	0.167
Primary	47 (40.2%)	413 (42.1%)
Secondary
History of endometriosis			<0.001
Yes	17 (1.7%)	19 (16.2%)
No	963 (98.3%)	98 (83.7%)
History of pelvic inflammatory disease			0.001
Yes	64 (6.5%)	21 (17.9%)
No	916 (93.5%)	96 (82.1%)
History of surgery			<0.001
Yes	39 (4.0%)	20 (17.1%)
No	941 (96.0%)	97 (82.9%)
History of polyps			0.004
Yes	49 (5.0%)	23 (19.7%)
No	931 (95.0%)	94 (80.3%)

Cervical stenosis and pregnancy rate after ultrasound guided cervical dilation in women undergoing saline infusion sonography

Article Category: research-article

Published Online: Jun 15, 2020

Page range: 116 - 121

Received: Feb 16, 2020

Accepted: Jun 01, 2020

DOI: https://doi.org/10.15557/jou.2020.0019

Keywords
cervical stenosis, conception, ultrasound-guided cervical dilation

© 2021 Polish Ultrasound Society. Published by Medical Communications Sp. z o.o.

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Fig. 1.

Fig. 2.

Characteristics of study population

Conception and time to pregnancy in women with cervical stenosis who received dilation vs those with no dilation

Comparison of both groups in terms of history parameters

Cervical stenosis and pregnancy rate after ultrasound guided cervical dilation in women undergoing saline infusion sonography

Article Category: research-article

Published Online: Jun 15, 2020

Page range: 116 - 121

Received: Feb 16, 2020

Accepted: Jun 01, 2020

DOI: https://doi.org/10.15557/jou.2020.0019

Keywordscervical stenosis, conception, ultrasound-guided cervical dilation

© 2021 Polish Ultrasound Society. Published by Medical Communications Sp. z o.o.

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Fig. 1.

Fig. 2.

Characteristics of study population

Conception and time to pregnancy in women with cervical stenosis who received dilation vs those with no dilation

Comparison of both groups in terms of history parameters

Keywords
cervical stenosis, conception, ultrasound-guided cervical dilation