Volume 11, Issue 12 (1-2013)                   IJRM 2013, 11(12): 977-0 | Back to browse issues page

XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Ahmadi F, Rashidy Z, Haghighi H, Akhoond M, Niknejadi M, Hemat M et al . Uterine cavity assessment in infertile women: Sensitivity and specificity of three-dimensional Hysterosonography versus Hysteroscopy. IJRM 2013; 11 (12) :977-0
URL: http://ijrm.ir/article-1-376-en.html
1- Department of Reproductive Imaging at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran , f_ahmadi@royaninstitute.org
2- Department of Reproductive Imaging at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
3- Department of Statistics, Mathematical Science and Computer Faculty, Shahid Chamran University, Ahvaz, Iran
4- Department of Endocrinology and Female Infertility at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
5- Department of Epidemiology and Reproductive Health at Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
Abstract:   (39381 Views)
Background: Assessment of uterine abnormalities is a core part in infertility evaluation.
Objective: The aim of this study was to evaluate the sensitivity and specificity of three-dimensional hysterosonography (3-DHS) in the diagnosis of uterine abnormalities in infertile women.
Materials and Methods: The infertile women who visited Royan Institute and referred to 3-DHS consecutively, prior to in vitro fertilization, from 2010-2011 included in this cross-sectional study. For patients who underwent hysteroscopy in addition to 3-DHS (214/977), the verification bias adjusted sensitivity and specificity of 3-DHS which were calculated by global sensitivity analysis method. Hysteroscopy was used as the gold standard for diagnosis of uterine abnormalities. Histological diagnosis of resected endometrial tissues by hysteroscopy was assessed and the adjusted sensitivity and specificity of 3-DHS and hysteroscopy in detection of polyp or hyperplasia were determined. Histopathologic results were considered as the gold standard for diagnosis of polyp or hyperplasia.
Results: The overall sensitivity and specificity for 3-DHS in diagnosis of uterine anomalies considering hysteroscopy as the gold standard were 68.4% and 96.3% respectively. Sensitivity and specificity of hysteroscopy in diagnose of polyp or hyperplasia was calculated at 91.3% and 81.4% respectively. Sensitivity and specificity of 3-DHS in diagnosis polyps or hyperplasia was calculated at 91.4% and 80.2 % respectively.
Conclusion: The results of present study proved that, compared to hysteroscopy; 3-DHS has a reliable specificity for diagnosis of uterine abnormalities. Sensitivity and specificity of 3-DHS and hysteroscopy in detecting polyp or hyperplasia regarding histopathology as the gold standard was the same.
Full-Text [PDF 141 kb]   (910 Downloads) |   |   Full-Text (HTML)  (385 Views)  
Type of Study: Original Article |

References
1. Pundir J, El Toukhy T. Uterine cavity assessment prior to IVF. Womens Health (Lond Engl) 2010; 6: 841-847. [DOI:10.2217/WHE.10.61]
2. Bingol B, Gunenc MZ, Gedikbasi A, Guner H, Tasdemir S, Tiras B. Comparison of diagnostic accuracy of saline infusion sonohysterography, transvaginalsonography and hysteroscopy in postmenopausal bleeding. Arch Gynecol Obstet 2011; 284: 111-117. [DOI:10.1007/s00404-010-1604-0]
3. Koskas M, Mergui JL, Yazbeck C, Uzan S, Nizard J. Office hysteroscopy for infertility: a series of 557 consecutive cases. Obstet Gynecol Int 2010; 2010: 168096. [DOI:10.1155/2010/168096]
4. Sylvestre C, Child TJ, Tulandi T, Tan SL. A prospective study to evaluate the efficacy of two- and three-dimensional sonohysterography in women with intrauterine lesions. Fertil Steril 2003; 79: 1222-1225. [DOI:10.1016/S0015-0282(03)00154-7]
5. Brown SE, Coddington CC, Schnorr J, Toner JP, Gibbons W, Oehninger S. Evaluation of outpatient hysteroscopy, saline infusion hysterosonography, and hysterosalpingography in infertile women: a prospective, randomized study. Fertil Steril 2000; 74: 1029-1034. [DOI:10.1016/S0015-0282(00)01541-7]
6. La Sala GB, Blasi I, Gallinelli A, Debbi C, Lopopolo G, Vinci V, et al. Diagnostic accuracy of sonohysterography and transvaginal sonography as compared with hysteroscopy and endometrial biopsy: a prospective study. Minerva Ginecol 2011; 63: 421-427.
7. Bartkowiak R, Kaminski P, Wielgos M, Bobrowska K. The evaluation of uterine cavity with saline infusion sonohysterography and hysteroscopy in infertile patients. Neuro Endocrinol Lett 2006; 27: 523-528.
8. Salim R, Lee C, Davies A, Jolaoso B, Ofuasia E, Jurkovic D. A comparative study of three-dimensional saline infusion sonohysterography and diagnostic hysteroscopy for the classification of submucous fibroids. Hum Reprod 2005; 20: 253-257. [DOI:10.1093/humrep/deh557]
9. Begg CB, Greenes RA. Assessment of diagnostic tests when disease is subject to selection bias. Biometrics 1983; 39: 207-216. [DOI:10.2307/2530820]
10. Ransohoff DF, Feinstein AR. Problems of spectrum and bias in evaluating the efficacy of diagnostic tests. N Eng J Med 1978; 299: 926-930. [DOI:10.1056/NEJM197810262991705]
11. Nishikawa H, Imanaka Y, Sekimoto M, Hayashida K, Ikai H. Influence of verification bias on the assessment of MRI in the diagnosis of meniscal tear. Am J Roentgenol 2009; 193: 1596-1602. [DOI:10.2214/AJR.08.2223]
12. Kosinski AS, Barnhart HX. A global sensitivity analysis of performance of a medical diagnostic test when verification bias is present. Stat Med 2003; 22: 2711-2721. [DOI:10.1002/sim.1517]
13. De Kroon CD, Jansen FW, Louwé LA, Dieben SW, van Houwelingen HC, Trimbos JB. Technology assessment of saline contrast hysterosonography. Am J Obstet Gynecol 2003; 188: 945-949. [DOI:10.1067/mob.2003.264]
14. Alaetebi F, Fayek W. Sonohysterography Is a Reliable and Accurate Method For Investigating Uterine Factor Infertility. Evidence Based Women's Health J 2011; 10: 100-107.
15. Diaferia D, Ragni G, Vegetti W, Colombo M, Arnoldi M, Crosignani P.G. Sonohysterography for Uterine Cavity Evaluation in Infertility Work-Up. Fertil Steril 2000; 74 (Suppl.): S30. [DOI:10.1016/S0015-0282(00)00806-2]
16. Makris N, Kalmantis K, Skartados N, Papadimitriou A, Mantzaris G, Antsaklis A. Three-dimensional hysterosonography versus hysteroscopy for the detection of intracavitary uterine abnormalities. Int J Gynaecol Obstet 2007; 97: 6-9. [DOI:10.1016/j.ijgo.2006.10.012]
17. Guven MA, Bese T, Demirkiran F, Idil M, Mgoyi L.Hydrosonography in screening for intracavitary pathology in infertile women. Int J Gynaecol Obstet 2004; 86: 377-383. [DOI:10.1016/j.ijgo.2004.05.005]
18. Acholonu Jr UC, Silberzweig J, Stein DE, Keltz M. Comparison of hysterosalpingography and sonohysterography to hysteroscopy for the evaluation of intrauterine abnormalities in infertile patients. Fertil Steril 2008; 90 (Suppl.): S454. [DOI:10.1016/j.fertnstert.2008.07.730]
19. Ayida G, Chamberlain P, Barlow D, Kennedy S. Uterine cavity assessment prior to in vitro fertilization: comparison of transvaginal scanning, saline contrast hysterosonography and hysteroscopy. Ultrasound Obstet Gynecol 1997; 10: 59-62. [DOI:10.1046/j.1469-0705.1997.10010059.x]
20. Aboulghar MM, Shoeir IK, Momtaz M, Mohammady Mel, Ezzat H. A comparative study of 2-dimensional sonohysterography versus 3-dimensional sonohysterography in infertile patients with uterine cavity lesions and abnormalities. Middle East Fertil Soc J 2011; 16: 67-71. [DOI:10.1016/j.mefs.2010.12.001]
21. Greenes RA, Begg CB. Assessment of diagnostic technologies. Methodology for unbiased estimation from samples of selectively verified patients. Invest Radiol 1985; 20: 751-756. [DOI:10.1097/00004424-198510000-00018]
22. Bates AS, Margolis PA, Evans AT. Verification bias in pediatric studies evaluating diagnostic tests. J Pediatr 1993; 122: 585-590. [DOI:10.1016/S0022-3476(05)83540-1]
23. Philbrick JT, Horwitz RI, Feinstein AR. Methodologic problems of excerise testing for coronary artery disease: groups, analysis and bias. Am J Cardiol 1980; 46: 807-812. [DOI:10.1016/0002-9149(80)90432-4]
24. Grimes DA. Diagnostic dilation and curettage: a reappraisal. Am J Obstet Gynecol 1982; 142: 1-6. [DOI:10.1016/S0002-9378(16)32276-1]
25. Silverberg SG. Problems in the differential diagnosis of endometrial hyperplasia and carcinoma. Mod Pathol 2000; 13: 309-327. [DOI:10.1038/modpathol.3880053]
26. Svirsky R, Smorgick N, Rozowski U, Sagiv R, Feingold M, Halperin R, et al. Can we rely on blind endometrial biopsy for detection of focal intrauterine pathology? Am J Obstet Gynecol 2008; 199: 115. [DOI:10.1016/j.ajog.2008.02.015]
27. Hamilton JA, Larson AJ, Lower AM, Hasnain S, Grudzinskas JG. Routine use of saline hysterosonography in 500 consecutive, unselected, infertile women. Hum Reprod 1998; 13: 2463-2473. [DOI:10.1093/humrep/13.9.2463]
28. Shokeir T, Abdelshaheed M. Sonohysterography as a first-line evaluation for uterine abnormalities in women with recurrent failed in vitro fertilization-embryo transfer. Fertil Steril 2009; 91 (Suppl.):1321-1322. [DOI:10.1016/j.fertnstert.2008.02.135]

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Designed & Developed by : Yektaweb