The Role of Saline Sonohysterography Prior to IVF/ICSI and its Impact on Assisted Reproduction Program Outcome in Egyptian Community

Aim: To assess the incidence of undiagnosed intrauterine pathology based on saline sonohysterography in women with normal transvaginal ultrasound and their impact on the success rate of Intracytoplasmic sperm injection in Egyptian community. Patients and methods: Two hundred qualified patients scheduled for first time Intracytoplasmic sperm injection treatment were divided into 2 groups each containing 100 patients. Group 1 did saline sonohysterography and cases with intrauterine lesions were treated by hysteroscopy prior to undergoing Intracytoplasmic sperm injection, while group 2 did Intracytoplasmic sperm injection without prior saline sonohysterography. The main outcome measures were undiagnosed intrauterine abnormalities as uterine anomalies and polyps, in addition to, pregnancy, miscarriage and on-going pregnancy rates. Results: Uterine lesions were found in 35% of cases undergoing sonohysterography, and 27 out of the 35 cases were treated by hysteroscopy. A significant difference in pregnancy rate and on-going pregnancy rate in favour of the sonohysterography group (P=0.04) and (P=0.031) respectively. Conclusion: Saline sonohysterography is a non-invasive method for the diagnosis of uterine abnormalities improving the outcome of IVF/ICSI cycles.