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  • Title: A comparison of Dextran 70 with carbon dioxide as the distention medium for hysteroscopy in patients with infertility or requesting reversal of a prior tubal sterilization.
    Author: Taylor PJ, Lewinthal D, Leader A, Pattinson HA.
    Journal: Fertil Steril; 1987 May; 47(5):861-3. PubMed ID: 2436954.
    Abstract:
    Our previous publications have demonstrated a high prevalence of hysteroscopic findings, particularly adhesions and polyps. It was the purpose of this study to compare the findings in 992 women in whom hysteroscopy was successfully performed by Dextran 70 with a similar group of 335 women in whom hysteroscopy was performed by CO2 as the distention medium. The incidence of uterine abnormalities in women with primary infertility, secondary infertility, and requesting reversal of sterilization when Dextran was used as the distention medium was 29%, 41%, and 33%, respectively, but only 7.2%, 11%, and 6%, respectively, when CO2 was used. It was concluded from these data that many of the findings of our preliminary studies were probably artifactual and a function of the technique of hysteroscopy and that our early reports must be read with caution. Hysteroscopy has been commonly used to evaluate infertile women. Problems with this technique have resulted in the discovery - especially of asymptomatic women - of polyps, adhesions, myomata, and septa. With the introduction of the Hamou hysteroscope, questions arose as to the possibility that identification of intrauterine lesions had diminished. This study compares the findings of hysteroscopy when performed with Dextran 70 with carbon dioxide used as the distention medium. The 1st group consisted of 508 women with primary infertility, 351 with secondary infertility, and 155 women requesting a reversal of a previous sterilization. The 2nd group consisted of 339 women, 164 with primary infertility, 118 with secondary infertility, and 57 requesting reversal of a previous sterilization. Incidence of uterine abnormality when Dextran 70 was used were 29% in women with primary infertility, 41% with secondary infertility, and 33% in those requesting a reversal of previous sterilization. The figures when C02 was used were 7.2%, 11%, and 6% respectively. Conclusions drawn were that the previous studies were both artificial and were a result of the technique of hysteroscopy and should be evaluated with caution.
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