LAUSR

Thank you for your interest in our study and the compliments given. We do understand that ultrasound guidance (USG) has been used by some colleagues, often in selected cases, during electric vacuum aspiration, or at the end of the procedure to confirm complete evacuation. However, there is no formal report in the literature on the routine use of USG throughout the whole procedure for manual vacuum aspiration (MVA) for the treatment of early pregnancy loss. We fully agree that wellplanned prospective studies are required. In fact, we have started a few months ago on a doubleblinded randomised controlled study on the use of Buscopan® for pain control in USGMVA (ChiCTR1800014590). We have also commenced a prospective cohort study to compare the intrauterine adhesion rate after USGMVA and traditional suction evacuation under general anaesthesia. Regarding the success rate of cytogenetic analysis of products of conception after USGMVA, we can confirm that since submission of our manuscript (Chung et al, 2018), our extended, consecutive series of 82 cases showed similar results with a successful rate of 92.7%, with a culture failure rate of 7.3%, confirming the value of USGMVA in cases where cytogenetic analysis is deemed desirable. Dr Jacqueline Pui Wah Chung and Prof. Tin Chiu LI on behalf of coauthors.