Uterine cavity evaluation in infertile patients with transvaginal sonography, saline infusion sonography and hysteroscopy

Authors

  • Neena Gupta Department of Obstetrics and Gynecology, GSVM Medical College, Kanpur, UP, India
  • Seema Dwivedi Department of Obstetrics and Gynecology, GSVM Medical College, Kanpur, UP, India
  • G. N. Dwivedi Department of Paediatrics, GSVM Medical College, Kanpur, UP, India
  • Bandana Sharma Department of Obstetrics and Gynecology, GSVM Medical College, Kanpur, UP, India
  • Pragati Gupta Department of Obstetrics and Gynecology, GSVM Medical College, Kanpur, UP, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20161682

Keywords:

Infertility, TVS, SIS, Hysteroscopy, Intrauterine anamolies

Abstract

Background: To compare diagnostic accuracy of Transvaginal sonography (TVS), Saline infusion sonography (SIS) and hysteroscopy in infertile women.

Methods: In a prospective study, 250 women with complaint of infertility underwent TVS and SIS. Diagnostic and operative hysteroscopy under general anaesthesia was then performed.

Results: Hysteroscopy with directed biopsy was considered as the gold standard. Endometrial polyp (n=25, 10%), submucosal fibroid (n=12, 4.8%), suspected intrauterine adhesions (n=4, 1.6%) and congenital uterine anamoly (n=2, 0.8%) were detected with TVS. In the evaluation with SIS results Endometrial polyp (n=34, 13.6%), submucosal fibroid (n=20, 18.1%), suspected intrauterine adhesions (n=5, 2%) and congenital uterine anamoly (3, 1.2%). Hysteroscopy results detected Endometrial polyp (n=32, 12.8%), submucosal fibroid (n=19, 7.6%), suspected intrauterine adhesions (n=8, 3.2%) and congenital uterine anamoly (n=5, 2%).

Conclusions: TVS is the primary investigative method for evaluating every infertile couple by means of uterine cavity and ovaries. Hysteroscopy is superior to SIS in diagnosis of intracavitatory abnormalities. However SIS has the advantage of being noninvasive, cheap, affordable, short duration and accurate method for uterine cavity evaluation.

References

Gonen Y, Casper RF, Jacobson W, Blankier J. Endometrial thickness and growth during ovarian stimulation: a possible predictor of implantation in in vitro fertilization. Fertil Steril. 1989;52:446-50.

Lashen H. Female infertility. In Luesley DM, Baker PN, editors. Obstetrics and Gynaecology. An evidence-based text for MRCOG. 1st edn. London: Arnold. 2004;568.

Bartkowiak R, Kaminski P, Wielgos M, Bobrowska K. The evaluation of uterine cavity with saline infusion sonohysterography and hysteroscopy in infertile patients. Neuroendocrinol Lett. 2006;27:523-8.

Mencaglia L, Hamou JE. Manual of hysteroscopy - Diagnosis and surgery. Endo-Press, Tuttlingen. 2001;33.

Rogerson L, Duffy S. The role of Hysteroscopy before IVF-ET. MEFS J. 2001;6:198-205.

De Jong P, Doel F, Falconer A. Outpatient diagnostic hysteroscopy. BJOG. 1990;97:299-303.

Syrop CH, Sahakian V. Transvaginal sonography detection of endometrial polyps with fluid contrast augmentation. Obstet Gynecol. 1992;79:1041-3.

Hucke J, de Bruyne F, Balan P. Hysterocopy in infertility-Diagnosis and treatment including falloposcopy. Kchli OR(ed): Hysteroscopy. State of the Art. Contrib Gynecol Obstet. 2000;20:13-20.

De Geyter Ch, Schmitter M, De Geyter M, Nieschlag E, Holzgreve W, Hermann PG. Prospective evaluation of the ultrasound appearance of the endometrium in a cohort of 1186 infertile women. Fertil Steril. 2000;73:106-13.

Cepni I, Ocal P, Erkan S, Saricali FS, Akhas H, Demikiran F, et al. Comparison of transvaginal sonography, saline infusion sonography and hysteroscopy in the evaluation of uterine cavity pathologies. Aust NZ J Obstel Gynaecol. 2005;45:30-5.

Kamel HS, Darwish AM, Mohamed SA: Comparison of transvaginal ultrasonography and vaginal sonohysterography in the detection of endometrial polyps. Acta Obstet Gynecol Scand. 2000;79:60-4.

Soares SR, Barbosa dos Reis MM, Camargos AF. Diagnostic accuracy of sonohysterography, transvaginal sonography, and hysterosalpingography in patients with uterine cavity diseases. Fertil Steril. 2000;73:406-11.

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Published

2017-01-05

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Original Research Articles