July 13th, 2020

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Three-Dimensional Saline Contrast Sonohysterography in Detecting Uterine Anomalies and Pathologies Among Subfertile Women and Women with Abnormal Uterine Bleeding
Authors:  Faryal A. Khan, M.D., Isamme Al Fayyad, R.N., M.A., Mohamad Al-Tannir, D.M.D., M.P.H., Shehnaz Hansoti, M.D., Roua Ali, M.D., and Dania Al-Jaroudi, M.D., M.H.A.
  OBJECTIVE: To assess the prevalence of uterine anomalies and pathologies among subfertile women and women with abnormal uterine bleeding (AUB) using 3-dimensional transvaginal scans (3D-TVSs) and 3D saline contrast sonohysterography (3D-SCSH).

STUDY DESIGN: A prospective cohort study was conducted over 3 years. The women were recruited from the outpatient department and Reproductive Endocrinology and Infertility Medicine Department. All wom-en of reproductive age, either with AUB or subfertility, underwent 3D-TVS. If initial 3D-TVS detected any uterine abnormality, then the patient was booked for 3D-SCSH. Uterine anomalies were recorded according to the new ESHRE/ESGE classification of uterine anomalies and compared in the 2 groups.

RESULTS: Total number of 3D-TVSs performed was 2,222: 1,477 women from the subfertile group and 745 from the AUB group. A total of 330 women required 3D-SCSH, of whom 215 (65%) were subfertile women and 115 (35%) had AUB. Uterine anomalies were found in 15 (7%) in the subfertile group and in 2 (1.7%) in the AUB group. Partial septate uterus was the most common finding in the subfertile group (n=7 [3.3%]), and dysmorphic uterus (n=2 [1.7%]) in the AUB group. Uterine polyps were the most common uterine pathology in both groups.

CONCLUSION: 3D-SCSH detects congenital uterine anomalies in subfertile and AUB patients. Its diagnostic accuracy may support the adoption of 3D-SCSH as a routine investigation in the evaluation of subfertile women prior to IVF.
Keywords:  3D transvaginal scan, sonohysterography; abnormal uterine bleeding; assisted reproductive techniques; infertility; subfertility; ultrasonography
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