Accuracy of Two-Dimensional Transvaginal Sonography and Office Hysteroscopy for Detection of Uterine Abnormalities in Patients with Repeated Implantation Failures or Recurrent Pregnancy Loss

Background We sought to compare diagnostic values of two-dimensional transvaginal sonography (2D TVS) and office hysteroscopy (OH) for evaluation of endometrial pathologies in cases with repeated implantation failure (RIF) or recurrent pregnancy loss (RPL). Materials and Methods This prospective stu...

Full description

Bibliographic Details
Main Authors: Marzieh Shiva, Firouzeh Ahmadi, Arezoo Arabipoor, Mansoureh Oromiehchi, Mohammad Chehrazi
Format: Article
Language:English
Published: Royan Institute (ACECR), Tehran 2018-01-01
Series:International Journal of Fertility and Sterility
Subjects:
Online Access:http://www.ijfs.ir/article_45448_663bdfa90ab2cfbfa1034cd9cdd693b7.pdf
_version_ 1819229631943802880
author Marzieh Shiva
Firouzeh Ahmadi
Arezoo Arabipoor
Mansoureh Oromiehchi
Mohammad Chehrazi
author_facet Marzieh Shiva
Firouzeh Ahmadi
Arezoo Arabipoor
Mansoureh Oromiehchi
Mohammad Chehrazi
author_sort Marzieh Shiva
collection DOAJ
description Background We sought to compare diagnostic values of two-dimensional transvaginal sonography (2D TVS) and office hysteroscopy (OH) for evaluation of endometrial pathologies in cases with repeated implantation failure (RIF) or recurrent pregnancy loss (RPL). Materials and Methods This prospective study was performed at Royan Institute from December 2013 to January 2015. TVS was performed before hysteroscopy as part of the routine diagnostic work-up in 789 patients with RIF or RPL. Uterine biopsy was performed in cases with abnormal diagnosis in TVS and/or hysteroscopy. We compared the diagnostic accuracy values of TVS in detection of uterine abnormalities with OH by receiver operating characteristic (ROC) curve analysis. Results TVS examination detected 545 (69%) normal cases and 244 (31%) pathologic cases, which included 84 (10.6%) endometrial polyps, 15 (1.6%) uterine fibroids, 10 (1.3%) Asherman’s syndrome, 9 (1.1%) endometrial hy- pertrophy, and 126 (15.9%) septate and arcuate uterus. TVS and OH concurred in 163 pathologic cases, although TVS did not detect some pathology cases (n=120). OH had 94% sensitivity, 95% specificity, 62% positive predictive value (PPV), and 99% negative predictive value (NPV) for detection of endometrial polyps. In the diagnosis of myoma, sen- sitivity, specificity, PPV, and NPV were 100%. TVS had a sensitivity of 50% and specificity of 98% for the diagnosis of myoma. For polyps, TVS had a sensitivity of 54% and specificity of 80%. Area under the ROC curve (AUROC) was 70.69% for the accuracy of TVS compared to OH. Conclusion TVS had high specificity and low sensitivity for detection of uterine pathologies in patients with RIF or RPL compared with OH. OH should be considered as a workup method prior to treatment in patients with normal TVS findings.
first_indexed 2024-12-23T11:16:15Z
format Article
id doaj.art-66370946b55842bea1bf4a34ddfbe236
institution Directory Open Access Journal
issn 2008-076X
2008-0778
language English
last_indexed 2024-12-23T11:16:15Z
publishDate 2018-01-01
publisher Royan Institute (ACECR), Tehran
record_format Article
series International Journal of Fertility and Sterility
spelling doaj.art-66370946b55842bea1bf4a34ddfbe2362022-12-21T17:49:13ZengRoyan Institute (ACECR), TehranInternational Journal of Fertility and Sterility2008-076X2008-07782018-01-0111428729210.22074/ijfs.2018.503445448Accuracy of Two-Dimensional Transvaginal Sonography and Office Hysteroscopy for Detection of Uterine Abnormalities in Patients with Repeated Implantation Failures or Recurrent Pregnancy LossMarzieh Shiva0Firouzeh Ahmadi1Arezoo Arabipoor2Mansoureh Oromiehchi3Mohammad Chehrazi4Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, IranDepartment of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, IranDepartment of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, IranDepartment of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, IranDepartment of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, IranBackground We sought to compare diagnostic values of two-dimensional transvaginal sonography (2D TVS) and office hysteroscopy (OH) for evaluation of endometrial pathologies in cases with repeated implantation failure (RIF) or recurrent pregnancy loss (RPL). Materials and Methods This prospective study was performed at Royan Institute from December 2013 to January 2015. TVS was performed before hysteroscopy as part of the routine diagnostic work-up in 789 patients with RIF or RPL. Uterine biopsy was performed in cases with abnormal diagnosis in TVS and/or hysteroscopy. We compared the diagnostic accuracy values of TVS in detection of uterine abnormalities with OH by receiver operating characteristic (ROC) curve analysis. Results TVS examination detected 545 (69%) normal cases and 244 (31%) pathologic cases, which included 84 (10.6%) endometrial polyps, 15 (1.6%) uterine fibroids, 10 (1.3%) Asherman’s syndrome, 9 (1.1%) endometrial hy- pertrophy, and 126 (15.9%) septate and arcuate uterus. TVS and OH concurred in 163 pathologic cases, although TVS did not detect some pathology cases (n=120). OH had 94% sensitivity, 95% specificity, 62% positive predictive value (PPV), and 99% negative predictive value (NPV) for detection of endometrial polyps. In the diagnosis of myoma, sen- sitivity, specificity, PPV, and NPV were 100%. TVS had a sensitivity of 50% and specificity of 98% for the diagnosis of myoma. For polyps, TVS had a sensitivity of 54% and specificity of 80%. Area under the ROC curve (AUROC) was 70.69% for the accuracy of TVS compared to OH. Conclusion TVS had high specificity and low sensitivity for detection of uterine pathologies in patients with RIF or RPL compared with OH. OH should be considered as a workup method prior to treatment in patients with normal TVS findings.http://www.ijfs.ir/article_45448_663bdfa90ab2cfbfa1034cd9cdd693b7.pdfdiagnosishysteroscopyultrasonographyuterine
spellingShingle Marzieh Shiva
Firouzeh Ahmadi
Arezoo Arabipoor
Mansoureh Oromiehchi
Mohammad Chehrazi
Accuracy of Two-Dimensional Transvaginal Sonography and Office Hysteroscopy for Detection of Uterine Abnormalities in Patients with Repeated Implantation Failures or Recurrent Pregnancy Loss
International Journal of Fertility and Sterility
diagnosis
hysteroscopy
ultrasonography
uterine
title Accuracy of Two-Dimensional Transvaginal Sonography and Office Hysteroscopy for Detection of Uterine Abnormalities in Patients with Repeated Implantation Failures or Recurrent Pregnancy Loss
title_full Accuracy of Two-Dimensional Transvaginal Sonography and Office Hysteroscopy for Detection of Uterine Abnormalities in Patients with Repeated Implantation Failures or Recurrent Pregnancy Loss
title_fullStr Accuracy of Two-Dimensional Transvaginal Sonography and Office Hysteroscopy for Detection of Uterine Abnormalities in Patients with Repeated Implantation Failures or Recurrent Pregnancy Loss
title_full_unstemmed Accuracy of Two-Dimensional Transvaginal Sonography and Office Hysteroscopy for Detection of Uterine Abnormalities in Patients with Repeated Implantation Failures or Recurrent Pregnancy Loss
title_short Accuracy of Two-Dimensional Transvaginal Sonography and Office Hysteroscopy for Detection of Uterine Abnormalities in Patients with Repeated Implantation Failures or Recurrent Pregnancy Loss
title_sort accuracy of two dimensional transvaginal sonography and office hysteroscopy for detection of uterine abnormalities in patients with repeated implantation failures or recurrent pregnancy loss
topic diagnosis
hysteroscopy
ultrasonography
uterine
url http://www.ijfs.ir/article_45448_663bdfa90ab2cfbfa1034cd9cdd693b7.pdf
work_keys_str_mv AT marziehshiva accuracyoftwodimensionaltransvaginalsonographyandofficehysteroscopyfordetectionofuterineabnormalitiesinpatientswithrepeatedimplantationfailuresorrecurrentpregnancyloss
AT firouzehahmadi accuracyoftwodimensionaltransvaginalsonographyandofficehysteroscopyfordetectionofuterineabnormalitiesinpatientswithrepeatedimplantationfailuresorrecurrentpregnancyloss
AT arezooarabipoor accuracyoftwodimensionaltransvaginalsonographyandofficehysteroscopyfordetectionofuterineabnormalitiesinpatientswithrepeatedimplantationfailuresorrecurrentpregnancyloss
AT mansourehoromiehchi accuracyoftwodimensionaltransvaginalsonographyandofficehysteroscopyfordetectionofuterineabnormalitiesinpatientswithrepeatedimplantationfailuresorrecurrentpregnancyloss
AT mohammadchehrazi accuracyoftwodimensionaltransvaginalsonographyandofficehysteroscopyfordetectionofuterineabnormalitiesinpatientswithrepeatedimplantationfailuresorrecurrentpregnancyloss