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Indian Journal of Obstetrics and Gynecology Research


Uterine cavity assessment prior to in vitro fertilization: comparison of 3D transvaginal ultrasonography accuracy versus office hysteroscopy


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Author Details: Vineet V. Mishra, Preeti A. Goyal, Raveendra P. Gondhali, Rohina S. Aggrawal, Sumesh D. Choudhary, S

Volume : 3

Issue : 3

Online ISSN : 2394-2754

Print ISSN : 2394-2746

Article First Page : 270

Article End Page : 273


Abstract

Objective: To compare accuracy of 3-D transvaginal sonography (TVS) versus office hysteroscopy (OH) in the evaluation of uterine cavity abnormalities in infertile women undergoing IVF procedures. OH considered as gold standard.
Study Design: A prospective observational study.
Settings: A tertiary care centre.
Materials and Methods: This is a prospective observational study conducted in 667 infertile women who were scheduled for IVF treatment at our department during June 2014 to December 2015. Main outcome measures- The prevalence of abnormal uterine cavity was 11.52% as detected by office hysteroscopy. There was failed hysteroscopy in 7 women due to cervical stenosis. 3D TVS and OH findings were normal in 631 (95.61%) and 584 (88.48%) women and abnormal in 29 (4.39%) and 76(11.52%) women respectively. This difference is statistically significant with p-value < 0.01. False positive and false negative results for 3 D TVS are 16(2.74%) and 63(82.89%). Considering OH as gold standard, 3 D TVS has 17.11% sensitivity, 97.26% specificity, 44.83% positive predictive value and 90.02% negative predictive value.
Conclusion: Uterine cavity abnormalities are considered to have a negative impact on the embryo implantation rates in IVF. OH should be considered as the primary modality to assess uterine cavity in IVF as it can be done without anesthesia and gives accurate diagnosis. Though 3 D TVS is easier, cost effective, non-invasive and have no complications as compared to OH but due to its low sensitivity (17.11%), low PPV (44.83%) and high false negative (82.89%) results, it has a limited role in IVF.

Keywords:
3 D TVS, OH, IVF, Uterine cavity, Implantation rates, Pregnancy