International Journal of Anatomy Radiology and Surgery (Jul 2020)

Comparison of Diagnostic Performance of Pathologies of Uterine Cavity by Transvaginal Sonography, Hysterosalpingography and Hysteroscopy in Infertility

  • Anupriya Gupta,
  • Shilpa Bhandari

DOI
https://doi.org/10.7860/IJARS/2020/43942:2544
Journal volume & issue
Vol. 9, no. 3
pp. 01 – 03

Abstract

Read online

Introduction: The interpretation of uterine pathology as a cause of female infertility represents a cardinal step in the appraisal of the infertile women. Common diagnostic modalities useful for the clinical assessment of the uterine cavity include: Transvaginal Sonography (TVS), Hysterosalpingography (HSG), hysteroscopy, hydrosonography and laparoscopy. Aim: To compare the diagnostic accuracy of TVS and HSG in evaluating uterine cavity in infertile women, considering hysteroscopy as gold standard. Materials and Methods: A prospective cross-sectional study was performed in which all infertile out patients attending the Department of Reproductive Medicine of Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India over the period of two years (October 2012-September 2014) were included. Patients diagnosed with primary and secondary infertility comprised of 321 infertile women with a mean age 24.9 years (range 20-45 years) were included and who underwent the required tests i.e., HSG, TVS, Hysteroscopy. The diagnostic accuracy of the procedures was calculated for each uterine disease separately. Pearson’s Chi-square and kappa test was used. Results: Hysteroscopy was used as a gold standard and showed normal cavity in 67.9% of the cases, uterine adhesions in 17.7%, uterine anomalies including arcuate uterus, septate uterus, uni and bicornuate uterus in 9%, polyp in 4% and fibroid in 0.9% of the cases HSG reported a specificity and Positive Predictive Value (PPV) of 100% for polyps and fibroids. The agreement between the three tests was found to be fair. No complications were recorded during hysteroscopy. Conclusion: The findings of HSG, TVS and hysteroscopy were fairly in agreement with each other and therefore it would be advised to choose the test in accordance to women’s preference.

Keywords