TY - JOUR AB - <p><strong>Objectives: </strong>To compare the diagnostic accuracy of three-dimensional transvaginal ultrasound (3D-US) to office hysteroscopy (OH) in the screening of uterine cavity with normal hysterosalpingography (HSG) findings for subtle endometrial abnormalities before in vitro-fertilization (IVF). <strong></strong></p> <p><strong>Methods: </strong>A prospective cohort cost-modeling study was carried out in a University hospital. We included 120 infertile women with a normal uterine cavity on HSG scheduled for IVF. All cases were evaluated by 3D-US, and the results were compared with OH findings.<strong></strong></p> <p><strong>Results: </strong>OH revealed cavitary endometrial lesions (CLs) in thirty-four women (28.3%). Endometrial polyps were the most common detected lesions (16, 47.1%). 3D-US had 88.2% sensitivity, 96.5% specificity, 90.9% positive predictive value, 95.4% negative predictive value, and 94.2% overall accuracy for CLs. The overall agreement between 3D-US and OH was near-perfect (κ=0.86, 95% CI=0.75-0.96). Irregular menstrual bleeds and prior endometrial procedures were significant predictors for CLs (aOR=24.96, 95% CI=2.71–230.04, P=0.005, aOR=9.16, 95% CI=2.13–39.3, P=0.002, respectively). A selective screening strategy discerning OH to women with these predictors and/or women with abnormal 2D-US would have an NPV of 92.8 % with substantial cost benefits. <strong></strong></p> <p><strong>Conclusions: </strong>In the pre-IVF work up, 3D-US, a non-invasive imaging modality, seems to be nearly comparable to OH. Office hysteroscopy screening prioritizing women with abnormal 2D-US, irregular menstrual periods and/or prior endometrial traumatization could yield a satisfactory cost-effective approach for identifying endometrial lesions.</p> AU - Ahmed M Abdelmagied, Momen A Kamel, Ahmed Abuelhasan, Ahmed Nassr, Sherif Shazly, Dina M Habib, Esraa Badran, Mohammed K. Ali, Abbas M Abbas DA - 2020/11// DO - 10.17077/2154-4751.1498 IS - 1 VL - 10 PB - Department of Obstetrics and Gynecology, The University of Iowa Hospitals and Clinics PY - 2020 TI - Undiagnosed endometrial abnormalities in women with normal hysterosalpingography scheduled for IVF: prospective evaluation of three-dimensional transvaginal ultrasound versus office hysteroscopy T2 - Proceedings in Obstetrics and Gynecology UR - https://pubs.lib.uiowa.edu/pog/article/id/3885/ ER -