Notes

Slide Show

Outline

1	One Stop Fertility Clinic Clinic analysis January 2000 to May 2004
2	OSFC January 2000 to May 2004
3	Patient suitability for OSFC January 2000 to May 2004
4	Patient details
5	Baseline investigations
6	Overall outcome of OSFC procedures
7	Reasons for cancelling investigations Hysteroscopy (n=18) Extreme anxiety, hyperventilation (6) Ovarian cyst on scan (5) Possible early pregnancy (2) Reduced uterine mobility (2) Unable to tolerate ve (1) History of chlamydia PID (1) Admission for ovarian drilling (1) Culdoscopy (n=31) As for Hysteroscopy PLUS Failed hysteroscopy (4) Adhesions suspected on ve (2) Extreme anxiety (2) Acutely retroverted uterus (1) Large fibroid uterus (1) Small pelvis (1) Loculated fluid in USS (1) Unable to tolerate uterine cannulation (1)
8	Learning curve for culdoscopy
9	Learning curve for culdoscopy
10	Abnormal findings
11	Site specific findings at culdoscopy
12	Technical outcome at culdoscopy
13	Procedure time Ultrasound + hysteroscopy + culdoscopy 41.2 (SD 17.2) minutes
14	Patient management
15	OSFC: Summary
16	Summary of our results OSFC-type approach is feasible Approx. 19:20 patients wish to come to OSFC Approx. 3:5 suitable on screening Approx. 1:5 investigations cancelled (mainly because of anxiety or pain) Approx. 1:5 culdoscopies unsuccessful Approx 3:10 found to have unsuspected pathology There are organisational issues
17	Perceived advantages of OSFC
18	Anxiety, pain and acceptability scores
19	Conclusions Advantages Less costly Single outpatient visit Immediate results Avoid general anaesthetic No need for admission Patient involvement Liked by patients Disadvantages Incomplete examination Not suitable for some Some will require laparoscopy Can be uncomfortable Risk of rectal trauma Needs good organisation