BACKGROUND: One of the basic steps of an infertility workup is to evaluate the shape and regularity of the uterine cavity, Hysteroscopy has been proved to be the definite method for evaluation of the uterine cavity. The advantages of 3D TVS as a noninvasive technique are that it is less expensive, does not require anesthetics, rarely leads to any complications, takes little time, does not influence the quality and histology of the endometrium.
Objectives: To evaluate the advantages and accuracy of Three-dimensional ultrasound (3D US) in assessing uterine intracavitary lesions and anomalies as a part in evaluating infertile females
METHODS: 50 females presented to the gynaecology and obstetrics department of Benha university hospital, recruited based on their complaint which was failure of conception. 3 D TVS and hysteroscopy were done for all patients between Augest 2014 to September 2016.
Results: In this study we found that hysteroscopy showed the following results; 4 cases revealed to be free from pathological lesions(8%),while the rest of the cases(92%) revealed lesions or abnormalities as follows:18 cases revealed submucous fibroids(36%), 13 cases revealed intrauterine polyps(26%), 11 cases revealed septate uterus(22%), and lastly 4 cases revealed to suffer from intrauterine adhesions(8%). Intrauterine adhesions were only found in cases of 2ry infertility.When comparing the two diagnostic tools together, 3D TVS was able to correctly classify 42 cases out of the 50 cases diagnosed by office hysteroscopy.3D TVS results compared to hysteroscopy showed the highest sensitivity in the diagnosis of myomas (100%), septateuterus (95.7%) followed by endometrial polypi (67.2%) then intrauterine synechia (65%).
CONCLUSIONS: After statistical analysisof these data , we concluded that, there was no difference in the results of 3D TVS and those of hysteroscopy in the diagnosis of submucousmyoma&septate uterus, In fact, 3D TVS offers greater advantage in accurate estimation of the size, consistency and vascularity which is not always apparent in hysteroscopy. However less accurate in the diagnosis of endometrial polyps and intrauterine adhesions.
The results of our study indicates the importance of 3D TVS as a screening tool for infertile patients with overall less patient discomfort, ease of storage and reproducibility, added benefit of visualizing the adnexa and free fluid in the Douglas pouch with using 3D SIS as anindication of tubal patency, all in one setting.. Hysteroscopy still remains the gold standard in diagnosing intrauterine lesions and abnormalities and offers the great advantage of surgical interventiona in the outpatient setting.
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