Jsl. Cunha et al., Accuracy of hysterosalpingography and hysteroscopy for diagnosis of intrauterine lesions in infertile patients in an assisted fertilization programme, GYNAEC ENDO, 10(1), 2001, pp. 45-48
Objective To determine the accuracy of hysterosalpingography compared with
hysteroscopy for detection of intrauterine abnormalities in infertile patie
nts.
Design Cross-sectional study.
Setting University hospital.
Subjects 296 women undergoing an assisted fertilization programme.
Intervention Patients Underwent to hysteroscopy and hysterosalpingography p
rior to intrauterine insemination or in vitro fertilization.
Main outcome measures Hysterosalpingographic and hysteroscopic findings.
Results Hysteroscopy proved satisfactory in 90.5% of cases. Of the patients
, 121 (40.9%) had an abnormal hysteroscopic evaluation. The most prevalent
hysteroscopic findings were: cervical stenosis (n = 28); chronic endometrit
is (n = 17); synechiae (n = 16); suspected endometrial hyperplasia (n = 14)
; polyps (n = 11); and myomas (n = 7). The comparison of hysteroscopic and
hysterosalpingographic findings revealed a sensitivity of 75.21% and a spec
ificity of 41.14% for hysterosalpingography; the positive and negative pred
ictive values were 47% and 70.60%, respectively.
Conclusions Hysterosalpingography is not sufficiently accurate, with regard
to specificity or sensitivity, for screening pathologies of the endometria
l cavity in infertile patients. Hysteroscopy should be performed in all pat
ients before IVF and artificial insemination.