Background: Hysteroscopy used to detect possible intrauterine causes ofinfertility. Misoprostol is a prostaglandin El analogue used in cervical ripeningbeforehysteroscopy to soften the cervix and decreasesthe force required for dilation.
Objectives: Comparing the effectiveness of oral versus vaginal misoprostol administered 24 hours before hysteroscopy to facilitate the procedures in infertile patients.
Patients and Methods:Our randomized control prospective study included 120 infertile women requiring hysteroscopy divided into three equal groups (Group A) received oral misoprostol with a dosage of 600 µg (200 µg / 8 hours), (Group B) receivedvaginal misoprostol with a dosage of 400 µg (200 µg /12 hours) and (group C) control group receivedoral placebo (one pill / 8 hours).Width of endocervical canal was assessed before the hysteroscope, the ease of entrance and the mean time needed for cervical dilation.
Results: Statistically substantial differences among the oral and vaginal groups (p < 0,009) and among the vaginal and control groups and the oral and control groups (p < 0,001 for both).There was a substantial difference in the ease of cervical entry among the vaginal and control groups and the oral and control groups (p < 0,001 for both), but not among the vaginal and oral groups (p < 0,998). The variation in time was not substantial between both the oral and vaginal groups.
Conclusion: Misoprostol is a good cervical ripening agent. Themove from the vaginal to the oral path, which more compliance by the patients, could applied without incurring a risk to clinical effectiveness.