Three-Dimensional Ultrasound versus Hysteroscopy in Uterine Cavity Assessment after Failed Intracytoplasmic Sperm Injection: a study for accuracy of a diagnostic test
Journal Title: The Egyptian Journal of Hospital Medicine - Year 2018, Vol 72, Issue 5
Abstract
<strong>Background: </strong>Implantation failure after intracytoplasmic sperm injection (ICSI) is related to either maternal factors or embryonic causes. The maternal factors include uterine anatomic abnormalities either congenital or acquired. Three-dimensional transvaginal ultrasound allows detailed evaluation of pelvic organs. Office hysteroscopy is the gold standard tool for visualization of intracavitary lesions and the cervical canal in an office-based environment. <strong>Aim of The Work: </strong>It was to compare between three-dimensional ultrasound (3D USS) and hysteroscopy for evaluation of the intrauterine cavity after trial of ICSI and to study the accuracy of diagnostic test in a tertiary care facility. <strong>Patients and Methods: </strong>It was a prospective; blinded; controlled clinical trial comparative study. Both hysteroscopy and 3D USS procedures were done for uterine cavity assessment after failed attempt of ICSI treatment for fifty-two asymptomatic infertile women. <strong>Results: </strong>Seventeen cases of our studied patients were without intracavitary or cervical lesions. From all studied cases, lesions (n=66) were seen either by hysteroscopy or by 3D USS where lesions (n=24) were seen by hysteroscopy and seen by ultrasound. Lesions (n=34) were seen by hysteroscopy. Lesions (n=36) were seen by ultrasound. Measure of agreement of Kappa was 0.273. Overall sensitivity of 3D USS was 70.59% and specificity 62.50% with positive predictive value (PPV) 66.67% and negative predictive value (NPV) 66.67%, accuracy was 66.67%, positive likehood ratio (LR+ve) 1.88% and negative likehood (LR-ve) 0.47%. The p-value was 0.026, which is statistically significant. <strong>Conclusion: </strong>It is important to investigate the uterine cavity in infertile women with history of unsuccessful ICSI. 3D USS has a good sensitivity and specificity for diagnosis of uterine cavity abnormalities and it could be used before hysteroscopy as a first line of investigation of intrauterine lesions.
Authors and Affiliations
Eman Helal
Keywords
Related Articles
- EP ID EP584183
- DOI 10.12816/ejhm.2018.9548
- Views 124
- Downloads 0
Assessment of Public Knowledge Regarding the Differences between Hyperthyroidism and Hypothyroidism
<strong>Background:</strong> Thyroid hormones play a pivotal role in the metabolism of human body. Changes of the thyroid gland activity manifest in nearly all body systems. Appropriate knowledge of the public about thyr...
Gender Differences in Characteristics of Colorectal Cancer Patients: Eight Years’ Experience in Tertiary Care Center.
<strong>Introduction and Objectives: </strong>Colorectal cancer (CRC) has become a very common researched topic in Saudi Arabia. Significance of the disease lay as the third most common cancer in the Kingdom plus the var...
Transverse Comparisons Between Ultrasound and Radionuclide Parameters in Children with Pelvi-Ureteric Junction Obstruction
Pelvi-ureteric junction (PUJ) obstruction is one of the causes of an obstructive uropathy which may be congenital or acquired. Ureteropelvic junction (UPJ) obstruction is a blockage at the point where ureters attaches to...
Effect of Sildenafil Citrate on the Outcome of in vitro Fertilization after Multiple IVF Failures Attributed to Poor Endometrial Development: A Randomized Controlled Trial
Aim of the work: this study aimed to evaluate the effect of sildenafil citrate on endometrial development in women with history of recurrent implantation failure after IVF. Setting: This study was conducted in obstetrics...
High Altitude and Related Illnesses Awareness among General Population in Albaha City
Background: high altitude illness (HAI) refers to a number of acute syndromes that may take place in individuals who are not acclimatized to high altitude, including acute mountain sickness, high altitude pulmonary edema...