| Abstrakt: |
Background: Uterine abnormalities, congenital or acquired are implicated as causal factor in 10%-15% of infertile couples reporting for treatment. Hysteroscopy, hysterosalpingography (HSG), saline-infusion-sonography and USG are available for evaluation of uterine cavity. HSG helps in initial evaluation of a sub-fertile woman, but hysteroscopy is gold standard as it allows direct visualisation of intrauterine pathology and treatment in same-setting, if required. Aims and Objective: To describe hysteroscopic findings of infertile patients and compare the observations with their respective HSG findings. Materials and Methods: It's a prospective analysis of 105 women with infertility who attended tertiary-care hospital during 18 months fulfilling pre-defined inclusion and exclusion criteria. All 105 infertility cases were evaluated with both HSG and hysteroscopy; observations were recorded and co-related with each other. Results: Among 105 cases, maximum (76.19%) were 25-35 years of age. The primary infertility accounted for 68.57% cases. Abnormal HSG findings observed in 19 cases (20%), most common being filling-defect. Hysteroscopy detected abnormalities in 39 cases (37.14%), commonest being endometrial polyp. Out of 39 cases of abnormal uterine cavity detected on hysteroscopy, only 19 were picked-up by HSG, rest 20 cases failed to be identified by HSG. The strength of agreement between hysteroscopy and HSG calculated is moderate (Kappa=0.505). Conclusion: As HSG had low false positivity (03%), high positive-predictive-value (90.48%) and negative-predictive-value (76.19%) and high specificity (96.96%) it is still considered as a first-choice screening method for uterine cavity. However, high false-negative-value (51.28%) of HSG makes hysteroscopy a better diagnostic test. HSG couldn't differentiate endometrial polyp, adhesions and sub mucous fibroid, shown them as filling defect only. [ABSTRACT FROM AUTHOR] |
