Accuracy of office hysteroscopy in the diagnosis of chronic endometritis

Amany Abdelbary Abdel Latif,Ibrahim Abdel Latif Ghanem,Marwa Said Shehata,Mohamed Elmahdy Abdel Moneim

doi:10.31083/j.ceog4902044

Amany Abdelbary Abdel Latif, Ibrahim Abdel Latif Ghanem + Show 2 more

Open Access

https://doi.org/10.31083/j.ceog4902044

Copy DOI

Abstract

Background: To test the accuracy of office hysteroscopy in the diagnosis of chronic endometritis (CE) as compared to histopathological diagnosis. Methods: This prospective cohort study was conducted in a private hospital from July 2018 to January 2020. 220 infertile women were scheduled for first attempt of intracytoplasmic sperm injection (ICSI). Patients ranging in age from 20–40 with history of primary infertility scheduled for ICSI for the first time were included, while patients with chronic diseases, severe vaginal bleeding, previous failed ICSI, polycystic ovary syndrome (PCOS), or endometriosis were excluded. All patients received postmenstrual office hysteroscopy to rule out the presence of CE; at the same setting, endometrial biopsy was taken and sent for histopathological examination. Results: 174 cases (79.1%) were diagnosed as CE at hysteroscopy, while 162 (73.6%) cases were positive at histopathology. 99.4% of the cases presented with hyperaemia, followed by oedema in 74.7% and micro-polypi in 58.6% of cases with CE. There was a significant difference between the hysteroscopic and the histopathologic diagnosis of CE (p < 0.001). The sensitivity, specificity, and positive and negative predictive values of hysteroscopy were 93.83%, 62.07%, 87.36% and 78.26% respectively. Conclusions: Office hysteroscopic evaluation is relatively accurate on its own but can be further confirmed by CD138 staining.

Highlights

Uterine factor infertility accounts for approximately 10–15% of infertile couples
The aim of this study was to test the accuracy of office hysteroscopy in the diagnosis of chronic endometritis as compared to histopathological diagnosis
The study was conducted on 220 women with complaints of primary infertility scheduled for the first attempt of intracytoplasmic sperm injection (ICSI)

Summary

Introduction

Uterine anomalies may be either congenital or acquired [1]. Congenital uterine malformations vary from subtle anomalies such as arcuate uterus to a major anomaly such as Mullerian agenesis. Specific entities in the acquired causes of uterine disease include intrauterine adhesions, abnormal caesarean scar, and scar niche [1]. To test the accuracy of office hysteroscopy in the diagnosis of chronic endometritis (CE) as compared to histopathological diagnosis. Patients ranging in age from 20–40 with history of primary infertility scheduled for ICSI for the first time were included, while patients with chronic diseases, severe vaginal bleeding, previous failed ICSI, polycystic ovary syndrome (PCOS), or endometriosis were excluded. Results: 174 cases (79.1%) were diagnosed as CE at hysteroscopy, while 162 (73.6%) cases were positive at histopathology. Conclusions: Office hysteroscopic evaluation is relatively accurate on its own but can be further confirmed by CD138 staining

Objectives

Methods

Results

Discussion

Conclusion