The association of intrauterine filling defects on hysterosalpingogram with endometriosis

Objective: To determine whether there is a significant association between the presence of polyps or polypoid endometrium on hysterosalpingogram (HSG) with the presence of pelvic or peritoneal endometriosis. Design: Retrospective chart review. Setting: Department of Reproductive Endocrinology and Infertility at the University of Vermont, College of Medicine. Patients: One hundred twenty patients, all of whom had a HSG, hysteroscopy, and laparoscopy by a member of our department between 1989 and 1993. Main Outcome Measure: Hysterosalpingograms were assessed for the presence of hypertrophic or polypoid endometrium, The presence of endometriosis was documented laparoscopically and scared according to The American Fertility Society classification and HSG findings were documented by hysteroscopy. Results: Endometriosis was found in 27 of 32 women with polyps or polypoid endometrium but in only 19 of 88 women without. chi(2) analysis revealed a significant association between the demonstration of polyps or polypoid endometrium on HSG and the presence of endometriosis, chi(2)(1) = 33.97. The predictive value of a positive test was 84% and the negative predictive value was 75%. Conclusion: The presence of polyps or polypoid endometrium on HSG is significantly associated with the presence of pelvic or peritoneal endometriosis.