AAGL 2013: Don’t Rule Out Cavity Abnormality Even After Normal Ultrasound

Fourteen percent of infertile patients have uterine cavity abnormalities despite normal ultrasound examination findings, according to the results of a new study presented on November 12 at the 42nd AAGL Global Congress on Minimally Invasive Gynecology held in National Harbor, Maryland.

All patients included in this retrospective review had normal findings on ultrasound examination of the uterus, said presenting author Carlos A. Souza, MD, of the Hospital de Clnicas de Porto Alegre, Brazil. Of 607 infertile patients who submitted to office hysteroscopy before undergoing an assisted reproductive technology procedure, Dr. Souza and colleagues found that 85 patients (14%) had some form of uterine cavity abnormality.

Of the 85 patients in whom a cavity abnormality was found, 43 had uterine polyps, 21 had uterine adhesions, 12 had uterine malformations, and 9 had submucosal leiomyomas. The study authors sought to determine what, if any, clinical markers are associated with uterine abnormalities when ultrasound examination findings are normal.

Analysis of various clinical factors, such as weight, age at menarche, gravity, parity, and others, showed that only age was significantly associated with uterine abnormalities. On average, women with uterine abnormalities were about 2 years older than women without uterine abnormalities (35.9 years vs 33.8 years, respectively; P=0.0001).

The take-home message: Cavitary evaluation before assisted reproductive technology procedures may be appropriate, particularly in older patients, even when the ultrasound findings are normal.