A comparison Assessment between Diagnostic Value of Hysterosalpingography (HSG) Versus Hysteroscopic Uterine Findings in Infertile Patients who Reffered to IVF Department of Ahvaz Imam Khomeini Hospital During 2010

Uterine pathology is the cause of infertility in 15% of infertile couples. Abnormalities of uterine cavity decrease fertility rate in patients who are undergoing IVF. Treatment of these abnormalities will improve fertility rate in these patients. Diagnostic evaluations of uterine cavity in infertile women are hystrerosalpingography and hysteroscopy. This study compared uterine findings in hysterosalpingography versus hysteroscopic in infertile patients. In this prospective descriptive epidemiological study, hysteroscopy uterine findings of 100 consecutive infertile women who referred to IVF unit of Imam Khomeini hospital in Ahvaz city compared with their hysterosalpingographic findings. These patients were candidate for hysteroscopy after hysterosalpingography. Analysis of findings was done by SPSS 16.0 and Windpipe 1.45.The concordance rate between two methods was assessed by kappa statistic. In this study, the results of uterine findings of HSG with hysteroscopy was compared. There was a sensitivity70%, specifity60%, false negative30%, false positive40%, positive predictive value80.3%, and negative predictive value46.2%. The agreement rate of the two methods was determined using kappa statistic which was 65%. (P-value < 0/005) our study showed that hysteroscopy increases 40% diagnostic power than HSG in uterine findings.(LR=1.4)Discussion & Hysteroscopy is better than HSG from the point view of assessing uterine cavity lesions even when HSG was normal, the diagnostic power was increase 40%. Hysteroscopy can be easily performed, and with respect to the fact that HSG has lower sensitivity and higher false negative rate than hysteroscopy, we suggest that hysteroscopy should be the part of assessing infertile couples.