Three-dimensional Ultrasound versusHysteroscopy for Evaluation ofEndometrial Compression in Patients with Fibroid Uterus Undergoing ICSI

Abstract

Uterine fibroid is the most common tumor in women of reproductive age. Depending on the size and location they can cause variety of symptoms. The clinical presentation may include bleeding disorders, infertility, pelvic pain and dysmenorrhea as well. In many women, myomas may be asymptomatic and are diagnosed incidentally on clinical examination or imaging. They are often found as part of the investigation of a couple presenting with infertility. Detection and precise evaluation of the number, size and location of myomas is possible due to advances in imaging and endoscopic methods. Treatment of fibroids depends on the severity and type of symptoms. There are medical, radiological and surgical options for treatment. Hysteroscopy offers a precise diagnosis and a better ground for therapy. It permits direct visualization of the uterine cavity, revealing the nature, location, shape, size and vascular pattern of any uterine cavity abnormalities, such as polyps and submucosal fibroids, but it provides only subjective assessment of fibroid size and indirect information regarding the depth of myometrial extension . Thus hysteroscopy is performed as a definitive diagnostic tool to evaluate any abnormality suspected on HSG or TVS in routine investigation of infertile patients. Although being an invasive procedure, it is considered as the gold standard for evaluation of the uterine cavity.