Comparative Study between Hysterosalpingography, Saline Infusion Transvaginal Ultrasound and Doppler Studies in Assessment of Uterine Factor of Infertility

Anwar, Mohammed Hesham Hassan; Ali, Osama Elsaeid; Abdelaziz, Bassem Ragab; Hassanin, Mohammed Abdalla

doi:10.21608/ejhm.2018.17219

Comparative Study between Hysterosalpingography, Saline Infusion Transvaginal Ultrasound and Doppler Studies in Assessment of Uterine Factor of Infertility

Document Type : Original Article

Authors

Obstetrics and Gynaecology Department, Faculty of Medicine, Al Azhar University

10.21608/ejhm.2018.17219

Abstract

Background: One of the basic steps of an infertility workup is to evaluate the shape and regularity of the uterine cavity. Acquired uterine lesions, such as uterine fibroids, endometrial polyps, intrauterine adhesions, or all of these, may cause infertility by interfering with proper embryo implantation and growth.
Aim of the Work: to compare the findings of hysterosalpingography, saline infusion transvaginal sonohysterography and Doppler studies in patients with suspected uterine causes of infertility. Patients and Methods: This is a comparative observational cross sectional study, which was conducted in the Obstetrics and Gynecology Department at Al Hussein and Sayed Galal University Hospitals, Al Azhar University in Cairo during the period from April 2017 to the end of September 2018. Sixty patients were included at the study who were recruited from the infertility outpatient clinics, with suspected uterine factors of infertility clinically, by hysterosalpingography (HSG) or by ultrasound. Results: HSG showed the highest sensitivity in the diagnosis of bicornuate uterus, septate uterus and intrauterine synechia (100%) followed by endometrial polyp (70%) then submucous myomas (62.5%). High specificity (100%) was in the diagnosis of endometrial polyp and submucous myoma. Also it showed high false negative values as it missed the diagnosis of 7 cases.
Conclusion: SIS is the gold standard of our study in assessment of uterine factor of infertility. Doppler studies showed high false negative results compared to HSG and saline infusion sonohysterography (SIS). Some lesions were missed from HSG and diagnosed by SIS and these missed lesions may play a role in infertility, so SIS is very important modality in diagnosis and assessment of uterine factor of infertility.

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