The role of transvaginal ultrasonography in the detection of pelvic pathologies in the infertility workup
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⤵ 24 in-corpus citations
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Transvaginal ultrasonography demonstrated high efficiency in detecting pelvic pathologies in infertile women, though it had limitations in characterizing pelvic adhesions accurately.
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Abstract
To assess the efficiency of transvaginal ultrasonography (TVUS) in the screening of pelvic pathologies in the initial workup of infertile women, we carried out a prospective comparison of sonographic diagnosis with laparoscopic and pathological findings. Between February 1994 and April 1995, 133 premenopausal non-pregnant women underwent TVUS on the day before laparoscopy. The efficiency of TVUS in detecting pelvic pathologies was 90.2% with a sensitivity of 86.2%, a specificity of 97.8% and positive and negative predictive values of 98.6 and 78.8% respectively. If the six false-negative cases with a histological diagnosis of minimal endometriosis were defined as 'normal pelvis', sensitivity and specificity could be corrected to 92.5 and 98.6% respectively. Endometriomas were diagnosed by TVUS with an efficiency of 96.4%, with a sensitivity and a specificity of 90 and 96.7 % and with positive and negative predictive values of 75 and 99.1% respectively. The sensitivity of vaginal sonographic characterization of pelvic adhesions was 61.1% with a specificity and positive predictive value of 98.2 and 84.6%. The negative predictive value of TVUS was 94.1%. These data suggest that it is not possible to characterize pelvic adhesions, especially filmy adhesions, with acceptable accuracy. However, in the initial workup of infertile women, if the patient is young, if both hysterosalpingography and TVUS are negative, laparoscopy could be postponed. In couples with severe male factor infertility and for whom in-vitro fertilization or intracytoplasmic sperm injection is the treatment of choice, laparoscopy might be avoided where the TVUS is negative.
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References (6)
- A comparative study between pelvic ultrasonography and laparoscopy in the detection of pelvic pathology in the initial workup of subfertile women via openalex
- Classification of Endometriosis via openalex
- Endometriosis-associated infertility via openalex
- Endometriosis detection by US with laparoscopic correlation via openalex
- W10868991 via openalex
- W2413678815 via openalex
Cited by (24)
- Navigating endometriosis diagnostic delay in 2040: Future directions in noninvasive diagnosis 2026
- Comparison of physical examination, ultrasound techniques and magnetic resonance imaging for the diagnosis of deep infiltrating endometriosis: A systematic review and meta-analysis of diagnostic accuracy studies 2020
- Imaging modalities for the non-invasive diagnosis of endometriosis 2016
- [Laparoscopy in ART?] 2015
- Does ovarian suspension following laparoscopic surgery for endometriosis reduce postoperative adhesions? An RCT 2014
- Endometriosis – Pathogenesis, Diagnosis, and Therapeutic Options for Clinical and Ambulatory Care 2013
- Ultrasonographic staging: a new staging system for deep endometriosis 2011
- Endometriose - Entstehung, Diagnostik, Behandlungsmöglichkeiten und Probleme in Klinik und Praxis 2011
- Ovarian endometriomas and IVF: a retrospective case-control study 2011
- [Diagnostic laparoscopy in current fertility practice: Pros] 2010
- Does controlled ovarian hyperstimulation in women with a history of endometriosis influence recurrence rate? 2010
- [Against the systematic practice of laparoscopy in infertility evaluation] 2010
- Diagnostic accuracy of transvaginal ultrasound examination for assigning a specific diagnosis to adnexal masses 2009
- Diagnosis of pelvic adhesions in patients with endometrioma: the role of transvaginal ultrasonography 2009
- Transvaginal ultrasonography in the diagnosis of extrauterine pelvic diseases 2008
- Fertilité tubaire et chirurgie : le point de vue du gynécologue 2007
- Imaging in gynecology 2006
- Investigations for chronic pelvic pain 2005
- [Is endoscopy useful in infertility treatment?] 2004
- Removal of endometriomas before in vitro fertilization does not improve fertility outcomes: a matched, case-control study 2004
- An ultrasound-based approach to the assessment of infertility, including the evaluation of tubal patency 2004
- The role of ultrasound in the management of women with acute and chronic pelvic pain 2004
- Transvaginal three-dimensional ultrasonography combined with serum CA 125 level for the diagnosis of pelvic adhesions before laparoscopic surgery 2003
- Modified hysterosalpingography during infertility work-up: use of contrast medium and saline to investigate mechanical factors 2000
Source provenance
- europepmc
- last seen: 2026-10-17T06:09:56.316927+00:00
- openalex
- last seen: 2026-06-10T17:14:06.276822+00:00
- pubmed
- last seen: 2026-10-08T22:00:35.617750+00:00
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