Fertility and Sterility
Volume 86, Issue 6 , Pages 1731-1735, December 2006

A prospective evaluation of uterine abnormalities by saline infusion sonohysterography in 1,009 women with infertility or abnormal uterine bleeding

Presented in part at the 60th annual meeting of the American Society for Reproductive Medicine, October 16–20, 2004, Philadelphia, PA.

  • Ilan Tur-Kaspa, M.D.

      Affiliations

    • Institute for Human Reproduction and Reproductive Genetics Institute, Chicago, Illinois
    • Corresponding Author InformationReprint requests: Ilan Tur-Kaspa, M.D., Director, Institute for Human Reproduction, 2825 N. Halsted Street, Chicago, IL 60657 (FAX: 773-935-3691).
    • ,
  • Michael Gal, M.D., Ph.D.

      Affiliations

    • Institute for Human Reproduction and Reproductive Genetics Institute, Chicago, Illinois
    • ,
  • Michael Hartman, B.A.

      Affiliations

    • True North Imaging, Thornhill, Ontario, Canada
    • ,
  • Jason Hartman, B.A.

      Affiliations

    • True North Imaging, Thornhill, Ontario, Canada
    • ,
  • Alex Hartman, M.D.

      Affiliations

    • True North Imaging, Thornhill, Ontario, Canada

Received 20 January 2006; received in revised form 12 May 2006; accepted 12 May 2006. published online 27 September 2006.

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).

Design

Prospective cohort study.

Setting

Academically oriented private practice.

Patient(s)

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

Intervention(s)

SIS.

Main Outcome Measure(s)

Intracavitary abnormalities and uterine anomalies.

Result(s)

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).

Conclusion(s)

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.

Key Words: Saline infusion sonohysterography, uterine anomalies, infertility, IVF, abnormal uterine bleeding, arcuate uterus, ART, hysterosonography

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PII: S0015-0282(06)03058-5

doi:10.1016/j.fertnstert.2006.05.044

Fertility and Sterility
Volume 86, Issue 6 , Pages 1731-1735, December 2006

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