Hysteroscopy versus transvaginal ultrasound in infertile women prior to intracytoplasmic sperm injection

Abstract

Objective The aim of this study was to compare the efficacy of transvaginal sonography (TVS) and hysteroscopy regarding the diagnosis of uterine cavity pathologies in a population of infertile women. Background The presence of uterine pathology may negatively affect the chance of implantation. Patients and methods A cross-sectional study at the Department of Obstetrics and Gynaecology at Menoufia University Hospital between March 2018 and March 2019 on 60 women who underwent TVS in the early follicular phase for detection of any uterine cavity abnormalities, followed by diagnostic hysteroscopy for all cases. Results The study included 60 women in the age range of 20–39 years. All cases were divided into two groups, women who were scheduled for first-time in-vitro fertilization (number 52) and women for recurrent in-vitro fertilization (number 8). The cases of primary infertility constituted 46.6% of all participants and 53.3% of cases were of secondary infertility. The abnormal uterine cavity was detected in about 25% of cases evaluated by TVS versus 45% of cases evaluated by hysteroscopy. Using hysteroscopy the most common uterine pathology was endometrial polyp which constituted 18.3% of all cases. TVS missed the diagnosis of 12 cases, three cases of polyps, two case of submucous fibroids, five cases of intrauterine septum, and two cases of intrauterine adhesions in comparison with diagnostic hysteroscopy. Conclusion Diagnostic hysteroscopy is superior to TVS in the diagnosis of intrauterine pathology. Office hysteroscopy takes little time comparable to TVS with little or no complications in experienced skilled hands. TVS has many screening parameters in the detection of polyps and submucous fibroids.