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

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.