Accuracy of three dimensional ultrasound and treatment outcomes of intrauterine adhesion in infertile women

Abstract

Objective: To determine the accuracy and usefulness of three-dimensional transvaginal ultrasound (3D-TVUS) in diagnosing intrauterine adhesion (IUA) and to evaluate treatment outcomes associated with fertility. Materials and Methods: IUA patients (110) underwent hysteroscopy to definitively diagnose and treat adhesiolysis. Morphologic characteristics of endometrium suggesting IUA, such as marginal irregularity, thinning, defects, obliteration, fibrosis, and calcification, were identified and recorded by 3D-TVUS. The sensitivity of 3D-TVUS findings and the attainment of postoperative fertility were evaluated prospectively. The clinical records were followed up for 2 years for obstetrical outcomes and analyzed. Results: On comparing the findings of 3D-TVUS with those of hysteroscopy in 110 patients, 45 (88.23%) patients were confirmed as IUA by hysteroscopy among 51 (46.36%) patients, with one finding in 3D-TVUS; 42 (97.67%) patients were confirmed among 43 (39.09%) patients with two findings; and 16 (100%) patients were confirmed among 16 (14.55%) patients with over three findings. A pregnancy rate of eight out of 47 (17.02%) was achieved in patients who desired fertility. Conclusion: 3D-TVUS assessment of the uterus provides an accurate depiction of adhesion and extent of cavity damage in patients with suspected IUA.

Keywords

• fertility
• intrauterine adhesion
• pregnancy
• three-dimensional transvaginal ultrasound
• uterine synechiae