Comparative study between Diagnostic Accuracy of 3D Ultrasound and Diagnostic Hysteroscopy in Uterine Cavity Assessment of Cases of Infertility

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Obstetrics and Gynecology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

Abstract

Background: One of the first and most fundamental things to do when investigating a woman who is unable to conceive is to examine her uterus. A healthy endometrium and a successful pregnancy depend on the uterine cavity maintaining its normal structure. Aim and objectives: To evaluate the uterine cavity more accurately using diagnostic 3D sonography compared to diagnostic hysteroscopy in infertile cases. Patients and methods: From January 2024 through October 2024, sixty patients were recruited for this prospective interventional trial from the outpatient obstetrics and gynecology clinics of Al-Azhar University Hospitals. The systematic random method was used for sample collection. Results: In our study, hysteroscopy detected normal uterine cavities in 61.6% of the cases, while 3D-TVS found normal results in 73.3%. While 3D-TVS was only able to detect endometrial polyps in 16.6% of cases, compared to 28.3% when using hysteroscopy, it was able to correctly diagnose five cases of submucous myoma and one case of septate uterus, but it missed seven polyps when using hysteroscopy. This discrepancy highlights the superior sensitivity of hysteroscopy for detecting smaller polyps. Conclusion: While 3D-TVS exhibited high specificity and moderate sensitivity, making it a valuable non-invasive diagnostic tool, it often missed smaller lesions that hysteroscopy successfully identified. Future advancements in 3D-TVS technology may improve its sensitivity, offering a more effective, non-invasive alternative to hysteroscopy in the clinical evaluation of uterine pathology.

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