3–7 September 2006, London, UK Poster abstracts rate of 96.8% (120/124). The patients did not found the procedure especially uncomfortable or painful and reported a high rate of satisfaction (97.3%). There were 3 patients with complications (1.6%). 2 vagal reactions just after the procedure with a quick recovery, and 1 pelvic inflammatory disease treated with antibiotics for a week. Conclusion: Ultrasound-guided extraction of lost intrauterine devices is a simple and safe procedure that may be performed before more invasive measures are attempted. P18.13 Does ultrasound guided fertiloscopy make it safer? K. Ojha 1 , A. Watrelot 2 , J. G. Grudzinskas 3 1 St George’s Hospital, United Kingdom, 2 Centre de Recherche et d’Etude de la Sterilite, France, 3 Bridge Fertility Centre, United Kingdom Fertiloscopy as a minimally invasive safe procedure that may be considered as an alternative to diagnostic laparoscopy in the routine assessment of women without clinical or ultrasound evidence of pelvic disease. On the basis of the additional advantages of fertiloscopy, namely salpingoscopy or microsalpingoscopy, it is considered that fertiloscopy could replace laparoscopy as a routine procedure in such women. (1). However there are concerns regarding the approach causing possible bowel damage. Although studies seem to show this is not the case (2) it has been a stumbling block in accepting this procedure in favor of laparoscopy. The authors performed the entire procedure under ultrasound guidance. The aspects of particular interest were introduction of the verres needle, fertiloscope applicator and fertiloscope along with the examination of the uterus, tubes and ovaries. There is a theoretical possibility that at the time introducing the verres needle damage may take place. By observing the entire entry procedure by ultrasound the risk is minimized and if not completely eliminated. The authors feel this is the first time fertiloscopy is performed under ultrasound guidance. Ultrasound guided operative technique may have a wider application which needs exploration. 1. Watrelot A, Nisolle M, Chelli H, Hocke C, Rongieres C, Racinet C; International Group for Fertiloscopy Evaluation. Is laparoscopy still the gold standard in infertility assessment? A comparison of fertiloscopy versus laparoscopy in infertility. Hum Reprod. 2003 Apr; 18 (4):834-9. 2. Gordts S, Watrelot A, Campo R, Brosens I. Risk and outcome of bowel injury during transvaginal pelvic endoscopy. Fertil Steril. 2001 Dec; 76 (6):1238–41. P18.14 Transvaginal ultrasonography and saline infusion sonography compared with outpatient hysteroscopy for the diagnosis of endometrial polyps and submucous fibroids Z. Haider 1 , E. Kirk 1 , B. Van Calster 2 , S. Van Huffel 2 , D. Timmerman 2 , T. Bourne 1 1 St. George’s Hospital, United Kingdom, 2 University Hospital Gathuisberg, Leuven, Belgium Objective: To compare the accuracy of transvaginal ultrasonography (TVS) and saline infusion sonography (SIS) with outpatient hysteroscopy (1.7 mm Versascope) for the detection of intrauterine polyps and submucous fibroids. Method: 76 women (68 premenopausal, 8 postmenopausal) booked for outpatient hysteroscopy underwent TVS and SIS and the findings were compared to outpatient hysteroscopy. Results: SIS had a greater sensitivity than TVS (52% to 80% (p < 0.001)) for detection of polyps and fibroids. Specificity showed a small, non-significant decrease (92% to 86%) comparing TVS with SIS. Negative predictive value (NPV) rose from 80% to 90%. With the addition of SIS the sensitivity improved much more for detection of polyps alone (49% to 85% p < 0.001) than it did for fibroids alone (62.2% to 68.8%). Folds of endometrium on SIS examination being misdiagnosed as lesions contributed to the fall in specificity and PPV. Conclusion: Use of saline infusion sonography improves the sensitivity for the detection of intrauterine fibroids and polyps but it is less accurate than outpatient hysteroscopy. Is there still a place for SIS when outpatient hysteroscopy is available? P18.15 The usefulness of ovarian volume using 3D vocal transvaginal ultrasound, antral follicle count and age as predictors of menopause in pre- and postmenopausal women Y. S. Kim , D. H. Bae, J. G. Sunwoo, S. D. Choi, J. S. Kim SoonchunHyang University Cheonan Hospital, Republic of Korea Objective: To evaluate the sensitivity and specificity of ovarian volume using 3D vocal and 2D ultrasound, antral follicle count, age as predictors of menopausal status in pre- and postmenopausal women. Methods: The subjects of this study were premenopausal (n = 76) and postmenopausal (n = 46) healthy women aged between 35 and 57 years of age who were interviewed about social, demographic, and medical conditions. These women underwent transvaginal ultrasound using 3D vocal and 2D probe to determine ovarian volume. Chai-square test was applied to evaluate the correlation between ovarian volume, antral follicle count, age and menopausal status. Receiver operating Characteristic (ROC) curves were elaborated to evaluate the sensitivity and specificity, positive and negative predictive values. Results: Premenopausal women presented larger ovaries than postmenopausal women (p < 0.01). Premenopausal women had a higher number of antral follicles than postmenopausal women (p < 0.01). ROC curves showed that antral follicle count and ovarian volume using 3D vocal transvaginal probe were more sensitive and specific markers of menopausal status than age or ovarian volume using 2D transvaginal probe. P18.16 Comparison of saline infusion sonography-guided endometrial sampling and endometrial biopsy in the diagnosis of endometrial pathology E. Moschos , D. M. Twickler University of Texas Southwestern Medical Center, United States Objective: To determine the feasibility and accuracy of saline infusion sonography-guided endometrial sampling in peri and postmenopausal women with abnormal uterine bleeding and nondiagnostic endometrial biopsies (EMBs). Methods: Twenty-one peri and postmenopausal women with abnormal uterine bleeding and nondiagnostic EMBs referred for saline infusion sonography underwent saline infusion sonography- guided endometrial sampling. The histopathologic diagnoses of endometrial biopsy and saline infusion sonography-guided endometrial sampling were compared. Statistical analysis was performed using a one-sided McNamar’s test. Ultrasound in Obstetrics & Gynecology 2006; 28: 512–614 607