The Diagnostic Value of Saline Infusion Sonohysterography Versus Hysteroscopy in Evaluation of Uterine Cavity in Patients with Infertility and Recurrent Pregnancy Loss

Abstract

Objective: To evaluate the sensitivity, specificity, positive and negative predictive values of saline infusion sonohysterography (SIS) in patients with infertility and recurrent pregnancy loss in comparison with hysteroscopy.

Materials and Methods: One-hundred sixty one women with infertility or recurrent pregnancy loss (RPL) were evaluated by SIS and hysteroscopy. The uterine cavity was inspected for irregularities as synechiae, polyps and submucous myomas, as well as uterine malformations.

Results: The mean age of patients was 35.32±6.43. Endometrial polyps were equally detected by both methods in the two groups. Submucous fibroids were more detected by SIS while intrauterine adhesions and congenital anomalies were more detected by hysteroscopy in both groups. The sensitivity, specificity, positive and negative predictive values of SIS in patients with infertility was higher than those with RPL (84.3 and 75%, 94.1 and 96.7%, 93.1 and 92.5, 74.4 and 67.9% respectively).

Conclusion: Hysteroscopy is superior to SIS in diagnosis of intracavitary abnormalities. However, saline infusion sonohysterography has the advantages of being non-invasive, cheap, affordable, shorter duration and accurate method for uterine cavity evaluation.