To compare the effectiveness of vaginal isonicotinic acid hydrazide with placebo in minimizing the pain experienced by primarily infertile patients during diagnostic office hysteroscopy and to assess the ease of insertion of hysteroscope as reported by the hysteroscopist.

hysteroscopy is commonly used in the diagnosis and treatment of intrauterine lesions such as polyps, fibroids, septa, and adhesions, and in the presence of abnormal bleeding and during the removal of an intrauterine device or foreign body. Cervical ripening is made possible by the use of medication through different routes.

Inclusion Criteria:

• nulliparous women with primary infertility requiring a diagnostic hysteroscopy as a part of an infertility diagnosis workup

Exclusion Criteria:

• women with suspected pregnancy
• heavy vaginal bleeding
• recent pelvic infection
• those known to have hypersensitivity or contraindication to isonicotinic acid hydrazide
• those who received analgesics prior to office heavy vaginal bleeding
• recent pelvic infection
• a concomitant neurologic disease that could affect the correct evaluation of pain

nulliparous women with primary infertility

double blind randomized controlled trial