Effectiveness of misoprostol for office hysteroscopy without anesthesia in infertile patients

Objective: To evaluate and compare the effectiveness of oral and vaginal misoprostol versus placebo to facilitate office hysteroscopy without anesthesia during infertile diagnostic evaluation. Design: Randomized, prospective trial. Setting: Patients scheduled for diagnostic office hysteroscopy at a university hospital. Patient(s): Seventy-five infertile patients scheduled for diagnostic office hysteroscopy. Intervention(s): Patients were divided into three groups: group A received oral misoprostol 600 mu g; group B, vaginal misoprostol 400 mu g; and group C, oral placebo. Main Outcome Measure(s): Pain, evaluated by visual analogue scale, and surgical time were recorded and compared. Statistical analysis was done using Student's t-test. Result(s): 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). Conclusion(s): Vaginal misoprostol, 400 mg, 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. (Fertil Steril(R) 2011;95:759-61. (C) 2011 by American Society for Reproductive Medicine.)