MONDAY, SEPTEMBER 4 37 Results : The efficacy of ovulation induction with puregon was 45% of pregnancy per woman and 37,5 % per cycle of stimulation, that can be compared with the efficacy of hMG treatment 43,3% per women and 37,1% per cycle. The frequency of OHSS developing occured in 10% of cases with puregon and 33,3% witn hMG.We noted no cases of undeveloping and multiple pregnancy with puregon. The rate of miscarriage and multiple pregnancy with hMG was 10%. The folliculogenesis induced by puregon was closer to parameters of spontaneous menstrual cycle in 25% of women 1 periovulatory follicle, spontaneous ovulation and average peak of estradiol(500-600 pmoV1) were noted. Conclusions : Ovulation induction using r-FSH has more advantages than hMG, such as reduced rate of complications : OHSS, multiple pregnancy and miscarriages. This happens because of the better physiologic parameters for the follicular development. It may increase the efficacy and safety of infertility treatment. FC1.12.09 URINARY FSH HAS STILL A SIGNIFICANT ROLE FOR OVULATION INDUCTION IN INFERTILE COUPLES. P.Fatima, D.Rahman, L.Shamsuddin, M.M.Hossain, Dept. Gynae, Bangabandhu, Sheikh Mujib Medical University, Dhaka, Bangladesh. Objectives : To observe the efficacy of recombinant FSH and urinary FSH in ovulation induction. Study Methods : A prospective random sampling was done from 938 patients undergoing ovulation induction in an infertility clinic in Dhaka, Bangladesh during the period from January 1997 to December 1999. 48 patients were selected for ovulation induction by Inj. Metrodin 48 patients by Inj.Puregon in the first ovulation induction cycle. Ovulation monitoring was done by transvaginal sonography only. Results : Out of 938 patients, 48 were selected for induction by Puregon and 48 by Metrodin. Primary infertility comprised 47.9% and 62.5% of the patients undergoing ovulation induction by Puregon and Metrodin respectively. 10.4% of the patients in Puregon cycle and 27% in Metrodin cycle conceived (at 5% level of significance, the p value is ~0.05). Mean ampoules of Puregon(5Oiu) and Metrodin(75iu) used were 6.9+ 4.3 and 5.9+ 2.6 respectively. In Puregon cycles, there was no abortion and in patients receiving Metrodin, abortion was in 6.3% cases. In both the groups anovulatory cycles comprised about 50% of the indications for ovulation induction followed by male factor, idiopathic, combined and uterine factor. Conclusion : Although fetal loss is more, urinary FSH has still significant role in patients undergoing ovulation induction. FC1.13 ULTRASOUND IN GYNECOLOGY FC1.13.01 INTEREST OF HYSTEROSONOGRAPHY IN THE PREOPERATIVE MANAGEMENT OF BENIGN UTERINE LESIONS JP. Bernard, S. Camatte, E. Rizk, I.Nahzah, F. LCcuru, R. Taurelle, Service Gyn&ologie, HBpital G Pompidou, Paris, France. Objectives: To assess the value of hysterosonography (HS) in the decision making of therapeutic options for benign intrauterine lesions. Study Methods: Patients scheduled for a surgical treatment because of abnormal bleeding were prospectively enrolled in a study conducted between January 1”’1996 and December 31”’ 1997. HS was used to establish further surgical management (hysterectomy or hysteroscopy). The end point of the study was to compare the surgical option ultimately carried out, with one decided after HS. Similarly, pathological results were juxtaposed to HS diagnosis. Statistical analysis used non- parametric and correlation tests. Results: 233 patients were included in the study, 39,5% of them were postmenopausal. HS was effective in the choice of the best surgical way, because no hysterectomy has been required when an operative hysteroscopy was indicated on HS data. Similarly, only one patient treated by hysterectomy (5.87) D could have been treated by a more conservative approach. HS correlated well with surgery for the location and size of intrauterine lesions (p<O.OOl). HS was accurate in the diagnosis of polyps and submucous myomas (sensitivity 85.7%, specificity 95,4%). Conclusions: HS appears as an interesting tool for pre-operative assessment of benign intrauterine pathologies. It should be used in the selection of patients that should be scheduled for an operative hysteroscopy. FC1.13.02 THE IMPACT OF INTRODUCING TRANSVAGINAL SONOGRAPHY f PIPELLE ENDOMETRIAL BIOPSY ON THE MANAGEMENT OF MENSTRUAL DISORDERS K. ReddL C. Absi, N. Amso, Dept. OBIGYN, University Hospital of Wales, Cardiff, U.K. Objectives: The aims were to determine Transvaginal scanning (TVS) findings in women with menstrual disorders, the need for further investigations and cost implications/savings of this practice. Study Methods: Over 15 months 239 women were referred to a TVS gynae-l-stop clinic. Data on 167 women with menstrual disorders (menorrhagiaepelvic pain=89, inter-menstrual bleeding=34 and post- menopausal bleeding=44) were collected prospectively and analyzed. Pipelle biopsy or hysteroscopy after TVS were regarded as intervetional procedures. Results: In the menorrhagia f pelvic pain group, 56 women had normal pelvis of whom 7 required pipelle sampling, 32 women had fibroids, 1 required hysteroscopy for possible polyp. Overall, the diagnostic intervention rate was 9%. In the true postmenopausal bleed (PMB) group, 15 patients needed diagnostic hysteroscopy, 10 required pipelle sampling, 2 had laparotomy for ovarian masses and 2 did not required any intervention. Additional 15 women required operative hysteroscopy resulting in a diagnostic intervention rate of 57%. Conclusions: The majority of scans in premenopausal women with menorrhagia were normal. The higher intervetion rate compared with the menorrhagia group (57% vs 9%) was necessary to exclude malignancy. However 40% were pipelle biopsies carried out in the clinic. The cost implications were most obvious in the premenopausal group and it could be argued that in the PMB group we had avoided 29 diagnostic hysteroscopies! FC1.13.03 TRANSVAGINAL ULTRASOUND SCANNNING IN A GYNECOLOGY-ONE STOP CLINIC. DOES IT HAVE A ROLE? N. K. Reddy, C. Absi, Dept. OBIGYN, University Hospital of Wales, Cardiff, UK Objectives: The aims of this study were to (1) evaluate the impact of transvaginal ultrasound (TVS) findings on clinical management and initiate appropriate action in one visit and (2) to determine the appropriateness of our selected gynecological referral categories for the concept of this clinic. Study Methods: 239 women were referred to this clinic between June 1998 and August 1999. We analyzed the prospective data of 226 women who met the referral criteria. The indications for referral were menstrual disorders, pelvic pain, suspected pelvic pathology, recurrent miscarriage and secondary infertility. The age group raged from 20-87 years. Results: In was shown that a definitive diagnosis was obtained and a management plan formulated at the first visit in 1971226 (87.16%_ women. TVS findings were inconclusive in 291226 (12.83%) women and further investigations were needed Only 301226 (13.2%) needed inpatient hysteroscopy for both therapeutic and diagnostic reasons and 101226 (4.4%) needed a diagnostic laparoscopy. The acceptance of TVS was evaluated in a subset of patients. All women attending the clinic were satisfied with the procedure. Conclusions: Our study demonstrates the effectiveness of TVS to arrive at a diagnosis and initiate appropriate treatment for the majority of this group of women during a single outpatient visit. It represents a major development for patients and the health service as it has the potential in reducing unnecessary interventions. FC1.13.04 ULTRASOUND DIAGNOSIS OF ENDOMETRIAL POLYPS A. B. JuhBsz, G. BacsM, T. Major, Z. Tbth, Dept. OBIGYN, University Medical School of Debrecen, Debrecen, Hungary. Objectives: To investigate the clinical significance and the power of ultrasound imaging techniques in the diagnosis of endometrial polyps.