title: The international agreement study on the diagnosis of the septate uterus at office hysteroscopy in infertile patients.
abstract: OBJECTIVE
  To assess the international agreement on the hysteroscopic diagnosis of septate uterus.
  
  
  METHODS
  Interobserver study.
  
  
  METHODS
  Eight hysteroscopy recordings were put online on the website of the European Society of Gynaecological Endoscopy.
  
  
  METHODS
  Asymptomatic, infertile women indicated for a first in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment cycle.
  
  
  METHODS
  Office hysteroscopy.
  
  
  METHODS
  The interobserver agreement on the uterine shape and necessity to correct the abnormality found.
  
  
  RESULTS
  Seventy-eight observers from 24 different countries assessed 8 hysteroscopy recordings. The interobserver agreement on uterine shape variations septate and arcuate was fair (intraclass correlation coefficient = 0.27). Observers from the same country reached a significantly higher level of agreement. The agreement on the necessity of correction was poor (intraclass correlation coefficient = 0.17). The most distinct features for diagnosing a septate uterus judged to be the extent of endocavitary bulging and the angle of the bulging structure from the fundal area.
  
  
  CONCLUSIONS
  The agreement among international experts on the hysteroscopic diagnosis of the septate uterus was found to be poor. This may have implications for the accuracy of screening hysteroscopy for diagnosing uterine cavity abnormalities in infertile patients. Development of consented definitions for the hysteroscopic diagnosis of septate and arcuate uterus is recommended.
authors.affiliation: Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands. j.smit-6@umcutrecht.nl
authors.forename: Janine G
authors.initials: JG
authors.lastname: Smit
authors.forename: Jenneke C
authors.initials: JC
authors.lastname: Kasius
authors.forename: Marinus J C
authors.initials: MJ
authors.lastname: Eijkemans
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: Veersema
authors.forename: Human M
authors.initials: HM
authors.lastname: Fatemi
authors.forename: Evert J P
authors.initials: EJ
authors.lastname: Santbrink van
authors.forename: Rudi
authors.initials: R
authors.lastname: Campo
authors.forename: Frank J M
authors.initials: FJ
authors.lastname: Broekmans
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D032921:Consensus; D003299:Cooperative Behavior; D005260:Female; D005298:Fertility; D005307:Fertilization in Vitro; D006801:Humans; D015907:Hysteroscopy; D007247:Infertility, Female / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D007391:International Cooperation; D016013:Likelihood Functions; D008875:Middle Aged; D015588:Observer Variation; D009819:Office Visits; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D020554:Sperm Injections, Intracytoplasmic; D014564:Urogenital Abnormalities / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D014599:Uterus / Q000002:abnormalities* / Q000503:physiopathology; D014741:Video Recording