Evaluation of outpatient hysteroscopy, saline infusion hysterosonography, and hysterosalpingography in infertile women: a prospective, randomized study.
OBJECTIVE
To compare the diagnostic accuracy, pain scores, and procedure length of outpatient hysteroscopy (OHS), hysterosalpingography (HSG), and saline infusion hysterosonography (SIS) for evaluation of the uterine cavity of infertile women.


METHODS
Prospective, randomized, investigator-blind study.


METHODS
Tertiary infertility clinic.


METHODS
Forty-six consecutive infertile women.


METHODS
Outpatient HSG, OHS, and SIS, followed by operative hysteroscopy (HS).


METHODS
Uterine abnormalities, procedure length, and subjective pain.


RESULTS
Fifty-nine percent of infertile subjects were found to have an abnormality on at least one of three outpatient uterine evaluations. When compared with the case of definitive operative HS, 60% of abnormalities were correctly classified by HSG, 72% by OHS, and 52% by SIS (P: NS). When comparing all combinations of 2 outpatient screening tests to operative hysteroscopy, 68% were correctly classified by HSG/OHS, 58% by HSG/SIS, and 64% by OHS/SIS (P: NS). The average time length for the OHS was 9.1 min., which was significantly greater than for both HSG (average, 5.3 min) and SIS (average, 6.1 min.) (P<.0001 for both). HSG and SIS were not statistically different regarding procedure time length. The average pain score (0-10) for SIS was 2.7, compared with 5.8 and 5.3 for HSG and OHS, respectively. Both HSG and OHS mean pain scores were significantly greater than the SIS mean.


CONCLUSIONS
OHS, SIS, and HSG were statistically equivalent regarding evaluation of uterine cavity pathology in infertile women.
Brown
S E
SE
Department of Obstetrics and Gynecology, The Jones Institute for Reproductive Medicine, Eastern Virginia Medical School, Norfolk, Virginia, USA. sambrown99@yahoo.com
Coddington
C C
CC
Schnorr
J
J
Toner
J P
JP
Gibbons
W
W
Oehninger
S
S
D000328:Adult; D000553:Ambulatory Care; D005260:Female; D006801:Humans; D007047:Hysterosalpingography; D015907:Hysteroscopy; D007247:Infertility, Female / Q000175:diagnosis*; D011446:Prospective Studies; D012965:Sodium Chloride; D014463:Ultrasonography; D014599:Uterus / Q000000981:diagnostic imaging*
D012965:Sodium Chloride