Artigo Original Accuracy of hysterosalpingography and hysteroscopy for diagnosis of intrauterine lesions in infertile patients in an assisted fertilization program Acurácia da histe rossalpingograf ia e h isteroscopia pa ra diagnóstico de lesões intrauteri nas em pacie ntes de um prog rama de fertil ização ass istida Cunha-Filho J. S. L., Salazar C. C ., Freitas F. M., Facin A. C., Passos E. P Hospital de Clínicas de Porto Alegre Setor de Reprodução Assistida Universidade Federal do Rio Grande do Sul Correspondência para: Prof Dr. Eduardo Pandolfi Passos Hospital de Clínicas de Porto Alegre Departamento de Ginecologia e Obstetrícia Universidade Federal do Rio Grande do Su l Ramiro Barcellos, 2350 - 1 1 Q andar 90000-003 Porto Alegre, RS - Brazil fax: + 55 51 34671 55 e-mail: epp@pro.via-rs.net Abstract To determine the accuracy ofhysterosalpingography with relation to hysteroscopy for detection of intrauterine abnormalities in inferti le patients. Design: Cross-sectional study.Setting : Univers ity hospital. Subjects: 375 women of an assisted fertilization programo Interventi on: Patients were submitted to hysteroscopy and hysterosalpingography prior to intrauterine insemination or in vitro fertilization. Main outcome measures: Hysterosalpingographic and hysteroscopic findings. Results: Hystero scopy proved satisfactory in 95.2% of cases . Two-hundred and twenty-two patients (62.2%) had a normal hysteroscopic evaluation. The most prevalent hysteroscopiç findings were: cervical stenosis (n=46); chronic endometritis (n=23) ; synechiae (n=23); endometrial hyperplasia (n=19); po lyps (n=17); and myomas (n =10). The comparison of histeroscopic and histerosalpingographic findings revealed a sensitivity of 52.3% and a specificity of 85.1 % for hysterosalpingography; the positive and negative predictive values were 65.7% and 76 .5%, respecti vely. Conclusions: Hysterosalp ingography is not sufficiently accurate or sensitive for screening pathologies of the endometrial cavity in inferti le patients. Hysteroscopy should be performed in alI patients before IVF and artificial insemination. Key words: hysteroscopy; ART; infertility, hysterosalpingography Introduction Most health care institutions consider hysteroscopy ' . (HSC) as the gold standard for diagnosing intrauterine abnormalities. Moreover, since HSC is a tolerahle and safe test, it can be carried out in outpatient settings, without anesthesia. (Ayuida et aI. 1997 and Gubbini et aI. 1 996). During the last few years, many authors have recommended the routine use of HSC for assessing the uterine cavity of infertile patients, especialIy of those who will be submitted to intrauterine insemination (IUI), or 1. Brasi/eil ReplVd. Assis/. - vol. 4 (I) janeiroljevereirlmarçolabri/ 2000 /9 DOI: 10.5935/1518-0557.2000.4.1.04