Evaluation of diagnostic accuracy of saline infusion sonography with hysteroscopy in infertile women

Infertility, defined as the inability to achieve pregnancy after one year of regular unprotected sexual intercourse, is a prevalent issue affecting couples worldwide. Among the various causes of infertility, uterine abnormalities have a significant prevalence, ranging from 34% to 62%. This study aimed to assess the effectiveness of saline infusion sonography (SIS) and hysteroscopy in evaluating uterine cavity abnormalities in infertile women. The inclusion criteria included primary and secondary infertility, while exclusion criteria involved active pelvic infection, unexplained genital tract bleeding, suspected pregnancy, and male factor infertility. The study was conducted prospectively in a hospital setting, and the majority of the infertile women were in the age group of 25-29 years. Primary infertility was observed in 75% of the subjects, while secondary infertility was seen in 25% of the patients. The results of SIS revealed the presence of endometrial polyps, submucosal fibroids, septum, and adhesions in various proportions. The overall sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SIS for diagnosing uterine anomalies were determined. However, hysteroscopy remains the gold standard for detecting uterine cavity abnormalities, with a sensitivity of 100% in identifying different structural anomalies and intrauterine adhesions. In conclusion, hysteroscopy is considered the superior technique for detecting uterine abnormalities, while SIS shows moderate sensitivity and specificity in diagnosing uterine anomalies in infertile women.