Abstract:

INTRODUCTION: To calculate sensitivity, specificity, positive and negative predictive values of transvaginal sonography (TVS) and hysterosalpingography (HSG) in the detection of intrauterine lesions, assuming hysteroscopy (H/S) and pathology results as gold standart, and to investigate the prevalance of intrauterine pathologies in primary and secondary infertile IVF patients who underwent H/S. METHODS: TThe present is a prospective cross-sectional study conducted with a total of 227 primary (Group 1) and secondary (Group 2) infertile patients who admitted to the Infertility and IVF clinic of Zeynep Kamil Training and Research Hospital between January and August 2013 and who underwent H/S. The procedure was performed in those with suspected intrauterine abnormalities or with two or more IVF failure. Primary outcome was to determine the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of TVS and HSG, assuming H/S as the gold standart test, in the detection of intrauterine abnormalities in primary and secondary infertile patient groups. Secondary outcome was to assess the prevalance of intrauterine pathologies based on the H/S results. RESULTS: Sensitivity, specificity, PPV and NPV of TVS in the detection of intrauterine abnormalities in Group 1 were 71%, 47%, 34% and 81%, respectively (p=0.042) and in Group 2 specificity and PPV were 69% and 16%, respectively (p=0.35) while in total patient group 72%, 49%, 33% and 84% (p=0.014). Measurement parameters of HSG in Group 1 were 57%, 46%, 74% and 29%, respectively (p=0.75) while in Group 2 60%, 36%, 71% and 25% (p=1) and in total patient group 55%, 48%, 74% and 28% (p=0.8). In H/S, 56.25% of patients with primary infertility and 36.8% of patients with secondary infertility were detected to have intrauterine abnormalities. DISCUSSION AND CONCLUSION: In detecting intrauterine abnormalities, TVS and HSG have similar sensitivity and spesificity values. However, NPV of TVS and PPV of HSG are higher. Use of TVS in the detection of intrauterine lesions as a diagnostic tool in total patient and primary infertile groups is statistically significant.

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