title: Comparison of hysterosalpingography and hysteroscopy in the evaluation of the uterine cavity in patients undergoing assisted reproductive techniques.
abstract: OBJECTIVE
  To investigate the diagnostic value of hysterosalpingography (HSG) for intracavitary and structural uterine pathologies in comparison with hysteroscopy (HS) in patients undergoing intracytoplasmic sperm injection-embryo transfer and also to specify the patients who should be subjected to HS in the early stages of an infertility work-up.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  IVF unit of a university hospital.
  
  
  METHODS
  Three hundred fifty-nine consecutive women who underwent both HSG and HS for infertility investigation.
  
  
  METHODS
  HS and HSG.
  
  
  METHODS
  HS findings.
  
  
  RESULTS
  HSG shows a sensitivity of 21.56%, specificity of 83.76%, positive predictive value of 55.26%, and negative predictive value of 70.75%. Its false-negative rate is 78.43%, and its false-positive rate is 16.23%. Overall agreement between the two procedures is 68.9%. The risk of abnormal HS increases with advancing patient age and duration of infertility. Risk increments associated with patient age over 35 years and increasing number of previous assisted reproductive techniques (ART) persist even in the presence of a normal HSG. As expected, we encounter significantly less abnormal HS in the male factor infertility group.
  
  
  CONCLUSIONS
  HS should be performed especially in patients older than 35 years of age and/or with a history of two or more previous ART trials even in the presence of a normal HSG. HSG shows unconvincing diagnostic value for intracavitary and structural uterine pathologies in infertility evaluation.
authors: In Vitro Fertilization Unit, Ankara University School of Medicine, Ankara, Turkey. eclamptic2000@yahoo.com
authors: Elif Aylin
authors: EA
authors: Taşkın
authors: Bülent
authors: B
authors: Berker
authors: Batuhan
authors: B
authors: Ozmen
authors: Murat
authors: M
authors: Sönmezer
authors: Cem
authors: C
authors: Atabekoğlu
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016009:Chi-Square Distribution; D004624:Embryo Transfer; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D005298:Fertility; D006785:Hospitals, University; D006801:Humans; D007047:Hysterosalpingography; D015907:Hysteroscopy; D007247:Infertility, Female / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D008875:Middle Aged; D011237:Predictive Value of Tests; D027724:Reproductive Techniques, Assisted; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D013997:Time Factors; D014421:Turkey; D014599:Uterus / Q000473:pathology* / Q000503:physiopathology; D055815:Young Adult