Abstract
Mohammad Ebrahim Parsanezhad *
Abstract
The hysteroscopy should be considered the stethoscope for the uterus (Dr. Linda Bradley). Though the uterus is critical for reproductive goals, we often turn to less accurate and more painful methods than this gold standard for uterine cavity evaluation. Intrauterine microscopic and macroscopic pathology can be detrimental to fertility. Hysteroscopy to identify macroscopic intrauterine disease is the gold standard. If prospectively comparing ultrasound, saline infusion sonography, and hysteroscopy for endometrial pathology, the relative sensitivities and specificities are 89% and 56%, 91.8% and 60%, and 97.3% and 92%, respectively . Sonography is more effective in evaluating intramural and extramural uterine disease such as type III– VII myomas and ovarian abnormalities, but it is more limited with corneal disease, sessile polyps, intrauterine adhesions, and endometritis. While three-dimensional ultrasound has even more potential than transvaginal and saline infusion sonography, identifying 100% of submucosal myomas and Mullerian anomalies, it still has a reduced sensitivity and specificity for polyps (61.1% and 91.5%, respectively) relative to hysteroscopy). Intrauterine pathology that can be identified with hysteroscopy and is likely to have an adverse effect on reproductive outcomes are Adenomyosis, Endometrial polyps, hyperplasia, and cancer, Endometritis, Intrauterine synechiae, Hysterectomy isthmocele, Leiomyoma, Mullerian anomalies, Retained products of conception, Tubal occlusion.