Comparison of ultrasonography and hysteroscopy in the diagnosis of intrauterine lesions in infertile women

Study Objective. To compare the effectiveness of transvaginal ultrasound versus hysteroscopy in the diagnosis of benign intrauterine lesions, with histology as the gold standard. Design, Retrospective study (Canadian Task Force classification II-1). Setting. Unit of Reproductive Medicine, Department of Obstetrics and Gynecology of Clinica Las Condes, Santiago, Chile. Patients, Infertile women who had undergone complete fertility evaluation. Intervention. Transvaginal ultrasound, hysteroscopy, and histologic evaluation of endometrial samples performed in all 126 women. Measurements and Main Results. The most frequent condition was a normal cavity (59.5%), followed by endometrial polyps (34.9%) and fibromyomas (3.9%). Synechiae and bone metaplasia were extremely rare. Sensitivity of transvaginal ultrasound for the diagnosis of endometrial polyps was 95.6% compared with 89.9% for hysteroscopy (NS). Specificity was 97.4% with transvaginal ultrasound versus 93.3% with hysteroscopy (NS). Positive and negative predictive values were similar for both methods. Conclusion. Transvaginal ultrasound is as effective as hysteroscopy in diagnosing benign intrauterine lesions. II could be the first clinical diagnostic test in the investigation of the uterine cavity.