I-34: Comparison between Hysteroscopy and Sonohysterography in Uterine Cavity Assessment

Intrauterine pathologies have been shown to be present in 25% of infertile patients.Structural abnormalities of the uterine endometrial cavity may affect the reproductive outcome adversely, by interfering with the implantation or causing spontaneous abortion. Intrauterine abnormalities may visualize using a variety of techniques. Including hysterosalpingography (HSG), transvaginal sonography (TVS), sonohysterography (SHG), and hysteroscopy. It has shown that three - dimensional saline contrast sonohysterography (3D-SCSH) is a reproducible method for the quantification of the percentage of a submucous fibroid protruding into the uterine cavity. Although hysteroscopy is currently accepted as the gold Standard for preoperative classification of submoucous fibroids, it has several disadvantages: using hysteroscopy is possible to measure the size of the fibroid and the degree of fibroid protrusion into the cavity based on the Subjective impression of the operator, rather than on an objective measurement. Further more, hysteroscopy can be technically difficult in women with large and multiple submoucous fibroids. In conclusion SCSH is a minimally invasive procedure that allows accurate visual assessment of the cervical canal and uterine cavity. The procedure of SCSH is acceptable and well tolerated by almost all patients. Therefore, SCSH should be part of the infertility work up before ART,even in patients with normal HSG and/or TVS, to ensure normality of the uterine cavity before ET.