![]() Saline infusion helps to delineate better intracavitary structures, thereby improving the diagnostic accuracy. SIS is a minimally invasive, cost-effective and acceptable diagnostic modality ( Pujar et al., 2010 Hajishaiha et al., 2011). Recent studies have reported poor sensitivity and positive predictive value (PPV) rates of transvaginal sonography in the detection of polypoid lesions ( Ragni et al., 2005 Bingol et al., 2011). While the transvaginal scan is generally performed to screen for uterine pathologies, its diagnostic accuracy is poor with pathologies like polyps, adhesions, and submucous fibroids being missed. The diagnostic modalities that are commonly employed to evaluate the regularity and shape of the uterine cavity include a conventional 2-D and 3-D transvaginal scan, saline infusion sonography (SIS), hysterosalpingogram (HSG) and hysteroscopy. It is therefore imperative that uterine abnormalities are diagnosed accurately as the surgical correction of these abnormalities may potentially improve the prospects of conception and a subsequent successful pregnancy ( Mollo et al., 2009 Pritts et al., 2009). Furthermore, these uterine cavity pathologies could be associated with adverse pregnancy outcomes, such as miscarriage and pre-term delivery, in addition to subfertility ( Pritts et al., 2009 Sunkara et al., 2010 Chan et al., 2011). Uterine cavity abnormalities are very common particularly in the subfertile population with a prevalence ranging from 11% to up to 45% ( Balmaceda and Ciuffardi, 1995 Hinckley and Milki, 2004 Fatemi et al., 2010 Chan et al., 2011). Uterine cavity abnormalities include polyps, fibroids, adhesions and congenital malformations, all of which could negatively affect the IVF outcome, and could be amenable to surgical treatment albeit based on poor scientific evidence. A favourable uterine cavity environment influences endometrial receptivity and any uterine cavity pathologies in subfertile women can therefore interfere with the implantation process ( Cakmak and Taylor, 2011). ![]() The most critical step for successful IVF outcome is embryo implantation, which is influenced by a positive cross talk between an adequate quality embryo and a receptive endometrium. ![]() Despite significant advances in assisted reproduction technology, the live birth rate after an IVF cycle is around 30% ( Andersen et al., 2008). One in seven couples have difficulty in conceiving and a majority of them undergo in vitro fertilization (IVF) treatment in order to maximize their chances of becoming pregnant ( NICE, 2004). Saline infusion sonography, sonohysterography, hysterosonography, hysteroscopy Introduction ![]()
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