Diagnostic Hysteroscopy versus Three Dimensional [3D] Transvaginal Ultrasonography in Unexplained Infertility

Abstract

Background: Infertility is becoming a bigger problem in society. Since hysteroscopy, the gold standard diagnostic method, is an intrusive procedure, a study that could get around its drawbacks was necessary. Hysteroscopy might be replaced by 3D transvaginal sonography [3D TVS], which simultaneously registers all three image planes and non-invasively visualizes uterine morphology.Aim of the work: Comparison between the diagnostic accuracy of 3D transvaginal ultrasound and diagnostic hysteroscopy in the evaluation of women with unexplained infertility.Patients and Methods: This comparative interventional study was conducted in the infertility clinic of Al-Azhar Cairo University Hospitals [Sayed Galal and El Hussein Hospitals] between February 2021 and February 2022. A total of one hundred women with unexplained infertility were enrolled and subjected to both 3D transvaginal sonography and diagnostic hysteroscopy.Results: Abnormalities that were detected by vaginal ultrasonography were intrauterine adhesions, which were detected in 20 [20%] cases; fibroid was found in 28 [28% cases]; intrauterine polyps were found in 25 [25% cases]; and septum was detected in 3 [3%] cases. By hysteroscopy, which is the gold standard in investigating the uterine cavity, abnormal findings were found in 90 cases, representing 90% of cases, whereas 10 [10%] cases were free.Conclusion: Three-dimensional transvaginal sonography is increasingly being used as a standard procedure to examine infertile women since it is excellent at detecting uterine cavity defects. Transvaginal sonography findings should be confirmed by hysteroscopy, the gold standard in uterine cavity investigation, as well as when transvaginal sonography produces conflicting results.

Keywords

• hysteroscopy
• three-dimensional transvaginal ultrasonography
• unexplained infertility