Abstract
Aim: To assess the incidence of undiagnosed intrauterine pathology based on saline sonohysterography in women with normal transvaginal ultrasound and their impact on the success rate of Intracytoplasmic sperm injection in Egyptian community. Patients and methods: Two hundred qualified patients scheduled for first time Intracytoplasmic sperm injection treatment were divided into 2 groups each containing 100 patients. Group 1 did saline sonohysterography and cases with intrauterine lesions were treated by hysteroscopy prior to undergoing Intracytoplasmic sperm injection, while group 2 did Intracytoplasmic sperm injection without prior saline sonohysterography. The main outcome measures were undiagnosed intrauterine abnormalities as uterine anomalies and polyps, in addition to, pregnancy, miscarriage and on-going pregnancy rates. Results: Uterine lesions were found in 35% of cases undergoing sonohysterography, and 27 out of the 35 cases were treated by hysteroscopy. A significant difference in pregnancy rate and on-going pregnancy rate in favour of the sonohysterography group (P=0.04) and (P=0.031) respectively. Conclusion: Saline sonohysterography is a non-invasive method for the diagnosis of uterine abnormalities improving the outcome of IVF/ICSI cycles.
Highlights
The uterus has an important role in reproduction
Saline sonohysterography had a sensitivity of 91.11%, specificity of 88.1%, and positive predictive value of 89.3%, negative predictive value of 90.7% and a diagnostic accuracy of 91% (Confidence Interval 95% for all these values)
The current study had no significant difference between both groups as regards the demographic data of the patients (Table 1), anti-Mullerian hormone (AMH) and basal follicle stimulating hormone (FSH) levels, number of HMG ampoules required per cycle, endometrial thickness at the day of ovum pick-up or number of follicles 18 mm. or more (Table 2)
Summary
To assess the incidence of undiagnosed intrauterine pathology based on saline sonohysterography in women with normal transvaginal ultrasound and their impact on the success rate of Intracytoplasmic sperm injection in Egyptian community. The aim of our study was to assess the incidence of undiagnosed intrauterine pathology based on saline sonohysterography in women with normal transvaginal ultrasound and their impact on the success rate of ICSI in Egyptian community
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