The Value of Transvaginal Sonography Performed before Diagnostic Hysteroscopy for the Evaluation of Uterine Cavity in Infertile Women


ABSTRACT:BACKGROUND:Hysteroscopy have gained general acceptance as a method for the investigation of infertility. The main advantage of hysteroscopy is the capability of inspecting the uterine cavity. Transvaginal sonography (TVS) is a noninvasive modality that provide excellent imaging of the uterus and of endometrial abnormalities. The present study was designed to evaluate the use of TVS as the initial diagnostic procedure before hysteroscopy for detecting intrauterine disorders.METHODS:Seventy-eight infertile women were examined by TVS and diagnostic hysteroscopy in the late follicular phase of the menstrual cycle and the results were compared.RESULTS:The uterine cavity abnormalities were present in 19.2% of the infertile females involved in the study. The Transvaginal sonography had 87.5% sensitivity, 100% specificity for detecting endometrial polyps while it had 100% sensitivity and 100% specificity for detecting other intrauterine cavity abnormalities including intrauterine adhesions, uterine septae and submucosal myomas.CONCLUSION:Examination of the uterine cavity is an integral part of any thorough evaluation of an infertile woman. Transvaginal sonography, when performed during the follicular phase, can detect most uterine cavity abnormalities. It was an accurate tool in the identification of intrauterine adhesions, uterine septae and submucosal fibroids.