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ORIGINAL ARTICLE
Year : 2020  |  Volume : 7  |  Issue : 2  |  Page : 223-229

Uterine cavity assessment prior to IVF: comparison of 2D, 3D ultrasound, and hysteroscopy


Southend Fertility & IVF Centre, New Delhi, India

Correspondence Address:
Dr. Sonia Malik
IVF Specialist in New Delhi India. Currently, She is Centre Head of Southend Fertility & IVF Centre; Dr. Sandeep Talwar, IVF Specialist in New Delhi, India. Currently, She is a Consultant in Southend Fertility & IVF Centre, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/fsr.fsr_45_20

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There is a conflicting evidence that prior hysteroscopy in IVF treatment is beneficial in terms of successful pregnancy rate and subsequent live birth rate. So a study was planned to compare 2D TVS & 3D USG in detecting uterine anomalies in infertile patients & to know whether prior hysteroscopy has any effect on Clinical Pregnancy and Abortion rate. A sample size of 90 was selected and further randomized into 3 groups. Patients were randomized over 6-month time. All patients underwent same baseline investigations. In group 1 subjects, 2D TVS was done to detect uterine anomalies, in group 2 3D USG was performed and group 3 subjects underwent gold standard diagnostic hysteroscopy. Subjects in group 1 & 2 who tested positive for uterine anomalies were confirmed with diagnostic hysteroscopy and subsequently excluded from the study. Those subjects who had false positive results in group 1 & 2 were included in group 3 for Frozen Embryo transfer. This procedure was done till each of the 3 groups had 30 subjects. Furthermore, subjects in group 1 & 2 who tested negative for uterine anomalies, underwent IVF but did not conceive further underwent diagnostic hysteroscopy to confirm the diagnosis as a part of calculating Sensitivity and Specificity of 2D TVS and 3D USG. A total of 160 patients were accessed and finally 90 were included in the study. There was no significant difference in baseline demographic characteristics, type of infertility, duration of infertility, hormonal profile & mean antral follicle count and size. The Sn, Sp, PPV for 2D TVS & 3D USG was found to be 66.6%, 90%, 75% & 90.9%, 95% and 90.9% respectively. There was no difference in CPR and miscarriage rate in patients who conceived in each group. The results of the study are in line with the previous studies. Larger scale RCTs need to be conducted to ascertain the exact role of prior hysteroscopy in pregnancy outcome in infertile patients with no uterine anomalies.


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