The evaluation of uterine cavity with saline infusion sonohysterography and hysteroscopy in infertile patients

Abstract

Objectives: The preliminary study was performed to evaluate the diagnostic accuracy of saline infusion sonohysterography (SIS) in the detection of intrauterine pathologies in infertile women The SIS findings were compared to the results of two widely used procedures: transvaginal sonography (TVS) and hysteroscopy (HS).

Material and methods: 68 infertile women, aged 27-42 were enrolled in the study. TVS, SIS and diagnostic HS were consecutively performed in every patient. The results of each method were compared. Sensitivity, specificity, positive predictive value and negative predictive values for TVS and SIS were obtained.

Results: Intrauterine pathologies were diagnosed in 25% of patients. TVS detected 6 (37.5%) and SIS revealed 11 (87.5%) of 13 intrauterine pathologies finally visualized at diagnostic hysteroscopy. TVS failed to visualize three submucous myomas, one endometrial polyp and two cases of septate uteri. All three cases of intrauterine synechiae were not detected with this method One submucous myoma and one endometrial polyp were not identified with SIS. The study group was, however, too limited to show statistically significant differences in diagnostic accuracy among TVS, SIS and HS.

Conclusions: Saline infusion sonohysterography is simple, sensitive and inexpensive diagnostic method. The procedure is not time-consuming, causes minimal discomfort to the patient and may be performed without anesthesia in office settings. The method may be recommended for the diagnosis of intrauterine pathologies in infertile women.