Al-Zinaty, F., Raafat, T., Ali, M., Al Sherbeeny, M. (2018). Three-Dimensional Ultrasound versus Hysteroscopy in Uterine Cavity Assessment after Failed Intracytoplasmic Sperm Injection: a study for accuracy of a diagnostic test. The Egyptian Journal of Hospital Medicine, 72(5), 4565-4571. doi: 10.21608/ejhm.2018.9548
Faten Mosbah Ibrahim Al-Zinaty; Tarek Aly Raafat; Mohammed Sayed Ali; Mohammed Mahmoud Al Sherbeeny. "Three-Dimensional Ultrasound versus Hysteroscopy in Uterine Cavity Assessment after Failed Intracytoplasmic Sperm Injection: a study for accuracy of a diagnostic test". The Egyptian Journal of Hospital Medicine, 72, 5, 2018, 4565-4571. doi: 10.21608/ejhm.2018.9548
Al-Zinaty, F., Raafat, T., Ali, M., Al Sherbeeny, M. (2018). 'Three-Dimensional Ultrasound versus Hysteroscopy in Uterine Cavity Assessment after Failed Intracytoplasmic Sperm Injection: a study for accuracy of a diagnostic test', The Egyptian Journal of Hospital Medicine, 72(5), pp. 4565-4571. doi: 10.21608/ejhm.2018.9548
Al-Zinaty, F., Raafat, T., Ali, M., Al Sherbeeny, M. Three-Dimensional Ultrasound versus Hysteroscopy in Uterine Cavity Assessment after Failed Intracytoplasmic Sperm Injection: a study for accuracy of a diagnostic test. The Egyptian Journal of Hospital Medicine, 2018; 72(5): 4565-4571. doi: 10.21608/ejhm.2018.9548
Three-Dimensional Ultrasound versus Hysteroscopy in Uterine Cavity Assessment after Failed Intracytoplasmic Sperm Injection: a study for accuracy of a diagnostic test
1Obstetrics and Gynecology Clinics, Al-Tayseer Clinics
2Department of Obstetrics and Gynecology, Faculty of Medicine, Ain-Shams University
Abstract
Background: Implantation failure after intracytoplasmic sperm injection (ICSI) is related to either maternal factors or embryonic causes. The maternal factors include uterine anatomic abnormalities either congenital or acquired. Three-dimensional transvaginal ultrasound allows detailed evaluation of pelvic organs. Office hysteroscopy is the gold standard tool for visualization of intracavitary lesions and the cervical canal in an office-based environment. Aim of The Work: It was to compare between three-dimensional ultrasound (3D USS) and hysteroscopy for evaluation of the intrauterine cavity after trial of ICSI and to study the accuracy of diagnostic test in a tertiary care facility. Patients and Methods: It was a prospective; blinded; controlled clinical trial comparative study. Both hysteroscopy and 3D USS procedures were done for uterine cavity assessment after failed attempt of ICSI treatment for fifty-two asymptomatic infertile women. Results: Seventeen cases of our studied patients were without intracavitary or cervical lesions. From all studied cases, lesions (n=66) were seen either by hysteroscopy or by 3D USS where lesions (n=24) were seen by hysteroscopy and seen by ultrasound. Lesions (n=34) were seen by hysteroscopy. Lesions (n=36) were seen by ultrasound. Measure of agreement of Kappa was 0.273. Overall sensitivity of 3D USS was 70.59% and specificity 62.50% with positive predictive value (PPV) 66.67% and negative predictive value (NPV) 66.67%, accuracy was 66.67%, positive likehood ratio (LR+ve) 1.88% and negative likehood (LR-ve) 0.47%. The p-value was 0.026, which is statistically significant. Conclusion: It is important to investigate the uterine cavity in infertile women with history of unsuccessful ICSI. 3D USS has a good sensitivity and specificity for diagnosis of uterine cavity abnormalities and it could be used before hysteroscopy as a first line of investigation of intrauterine lesions.
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