A prospective evaluation of uterine abnormalities by saline infusion sonohysterography in 1,009 women with infertility or abnormal uterine bleeding.
OBJECTIVE
To evaluate the role of saline infusion sonohysterography (SIS) in the investigation of uterine abnormalities and malformations in patients referred for infertility work-up compared with women with abnormal uterine bleeding (AUB).


METHODS
Prospective cohort study.


METHODS
Academically oriented private practice.


METHODS
One thousand nine consecutive women examined by SIS for infertility work-up (n = 600, infertility group) or AUB investigation (n = 409, AUB group).


METHODS
SIS.


METHODS
Intracavitary abnormalities and uterine anomalies.


RESULTS
Among the women in the infertility group, 16.2% (n = 97) were found to have intracavitary abnormalities, including polyps (13.0%), submucous fibroids (2.8%), and adhesions (0.3%). Significantly, more patients in the AUB group (39.6%, n = 162) revealed intracavitary abnormalities, including polyps (29.8%), submucous fibroids (9.0%), and adhesions (0.7%). In contrast, significantly more uterine anomalies were found in the infertility group (20%, n = 120) compared with the AUB group (9.5%, n = 39). Arcuate uterus was the most common finding (15% vs. 6.4% of patients, respectively).


CONCLUSIONS
An SIS procedure for infertility work-up revealed a substantial percentage of infertile patients with intracavitary abnormalities and uterine anomalies. Because the technique is safe, well tolerated, and feasible in an outpatient setting, SIS should be considered routinely in the early stage of infertility and AUB investigation.
Tur-Kaspa
Ilan
I
Institute for Human Reproduction and Reproductive Genetics Institute, Chicago, Illinois 60657, USA. iturkaspa@aol.com <iturkaspa@aol.com>
Gal
Michael
M
Hartman
Michael
M
Hartman
Jason
J
Hartman
Alex
A
D000282:Administration, Intravaginal; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007247:Infertility, Female / Q000150:complications / Q000000981:diagnostic imaging*; D007263:Infusions, Parenteral; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012965:Sodium Chloride / Q000008:administration & dosage; D014463:Ultrasonography / Q000379:methods*; D014592:Uterine Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging*; D014599:Uterus / Q000002:abnormalities* / Q000000981:diagnostic imaging*
D012965:Sodium Chloride