P29.05: Role of two‐dimensional ultrasound to detect uterine canalisation defects in infertile women

Abstract

To compare uterine transverse diameter in women with normal uteri and women with uterine canalisation defects as well as to assess its performance for ruling out these defects. Retrospective analysis of prospectively collected data in a series of selected women with primary or secondary infertility. All women underwent transvaginal 2D ultrasound and the uterus was measured in the three-orthogonal planes. The uterine transverse diameter (UTD) was recorded for analysis. Then 3D volume box was activated and a 3D volume including the whole uterine corpus was acquired for subsequent off-line analysis inn order to identify a canalization defect using the coronal plane in the multiplanar display Uterine transverse diameter (UTD) measured in 2D ultrasound from normal uteri was compared with that of arcuate, subseptated and septated uteri. ROC curve was plotted to determine the best UTD cut-off for discriminating between a normal and an abnormal uterus. 421 women (patient's mean age: 33.5 years, SD: 6.3, range: 18-45 years) were ultimately evaluated.Two-hundred and thirty (54.6%) women had a normal uterus, one hundred and twenty-four (29.4%) had an arcuate uterus, twenty-six (6.2%) women had a subseptated uterus and forty-one (9.8%) had a septated uterus.UTD was significantly larger in women with arcuate (53.3 mm, SD: 6.3, p < 0.05), subseptated (55.0 mm, SD: 6.7, p < 0.05) and septated uterus (56.0 mm, SD: 4.8, p < 0.05) as compared with normal uterus (45.9 mm, SD: 7.1). ROC curve showed that the best UTD cut-off for ruling out the presence of a uterine canalisation defect was 45 mm (AUC: 0.809, 95% CI: 0.768-0.849) (negative predictive value: 100%, sensitivity: 100%, specificity: 47%). Measurement of UTD may be a simple and practical method for ruling out a uterine canalisation defect in infertile women.