Open Access Maced J Med Sci. 2021 Sep 18; 9(B):917-920. 917 Scientifc Foundation SPIROSKI, Skopje, Republic of Macedonia Open Access Macedonian Journal of Medical Sciences. 2021 Sep 18; 9(B):917-920. https://doi.org/10.3889/oamjms.2021.6884 eISSN: 1857-9655 Category: B - Clinical Sciences Section: Gynecology and Obstetrics Evaluation of Uterine Cavity Abnormality using Saline Infusion Sonohysterography Before In Vitro Fertilization Ichwanul Adenin, Hilma Putri Lubis* , Binarwan Halim Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia Abstract BACKGROUND: Some studies suggested that saline infusion sonohysterography (SIS) has been used to detect uterine cavity abnormalities before in vitro fertilization (IVF) cycles to improve treatment success rates and decrease the number of cycle cancellations and embryo implantation failures. Some of the factors contributing to the dissemination and acceptance of the technique include the fact that it is a simple, less painful, less expensive, less invasive, and well-tolerated procedure when compared to hysteroscopy. AIM: The aim of the study is to evaluate uterine cavity abnormality with SIS performed before IVF. METHODS: A descriptive retrospective study involving 551 female partners who had SIS before IVF/ICSI treatment at private Halim Fertility Center from January 2014 until December 2017. Five hundred and ffty-one infertile woman was included in this study before IVF/ICSI cycles. Patients agreed to have an ultrasound assessment of the uterine cavity with the use of saline as the contrast medium. SIS procedure was scheduled postmenstrual period in the early- mid follicular phase and 1-3 months before starting IVF/ICSI treatment. RESULTS: From 551 patients, we found 527 (94.4%) cases with the normal uterine cavity. The uterine cavity abnormalities were detected in 5.56% of cases included in this study (28 (5.02%) cases with endometrial polyps, two (0.36%) cases with intrauterine adhesions, and one (0.18%) case with Müllerian duct anomalies). CONCLUSION: SIS before IVF treatment could be a good option for evaluating uterus cavity before IVF to improve success rates of pregnancy. Edited by: Ksenija Bogoeva-Kostovska Citation: Adenin I, Lubis HP, Halim B. Evaluation of Uterine Cavity Abnormality using Saline Infusion Sonohysterography Before In Vitro Fertilization. Open Access Maced J Med Sci. 2021 Sep 18; 9(B):917-920. https://doi.org/10.3889/oamjms.2021.6884 Keywords: Saline Infusion Sonohysterography; In vitro fertilization; Uterine cavity; Screening; Infertility *Correspondence: Hilma Putri Lubis, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia. E-mail: hilmaputrilubis@gmail.com Received: 21-Jul-2021 Revised: 19-Aug-2021 Accepted: 14-Sep-2021 Copyright: © 2021 Ichwanul Adenin, Hilma Putri Lubis, Binarwan Halim Funding: This research did not receive any fnancial support Competing Interests: The authors have declared that no competing interests exist Open Access: This is an open-access article distributed under the terms of the Creative Commons Attribution- NonCommercial 4.0 International License (CC BY-NC 4.0) Introduction Infertility is associated with the uterine cavity abnormalities that are thought to be a contributing factor of 10–15% of couples requiring treatment. An abnormal intrauterine fnding is estimated to occur in about 34–62% of infertile women. Because of the high prevalence of uterine abnormalities, the evaluation of the uterine cavity is routinely performed on the basic evaluation of infertile women [1], [2]. The outcome of assisted reproductive technique largely depends on the receptivity of the endometrial lining of the uterus. Measures aimed at evaluating the uterine cavity before treatment are very vital for decision making and hence contribute to the overall success rate. The true prevalence of intrauterine lesions in infertile women is not known but some studies have reported an incidence of about 16–24% [3]. The diagnostic modalities that are commonly employed to evaluate the regularity and shape of the uterine cavity include a conventional 2-dimensional (2-D) and 3-D transvaginal scan, saline infusion sonography (SIS), hysterosalpingogram, and hysteroscopy [3], [4]. Over the last three decades, SIS has become an integral part of ultrasound imaging in gynecology. SIS is a technique that can show better visualization of the uterine cavity than conventional transvaginal ultrasound (TVS). SIS is done by inserting the liquid gradually into the uterine cavity through a catheter inserted into the cervix. Some of the factors contributing to the dissemination and acceptance of the technique include the fact that it is a simple, less painful, less expensive, less invasive, and well-tolerated procedure when compared to hysteroscopy [4], [5]. In addition, SIS can provide detailed information about the uterus and endometrium. SIS is indicated in the evaluation of the uterine cavity of women with abnormal pre- and post- menopausal uterine bleeding, infertility, recurrent pregnancy loss, suspected uterine cavity abnormality, myoma, polyps, or synechiae. SIS should not be performed on women who are pregnant or women planning to become pregnant or in women with pelvic infection or unexplained pelvic tenderness. SIS with the use of TVS for evaluation of abnormal uterine bleeding was frst described by Bonilla- Musoles in 1992 [5], [6], [7]. SIS provides the beneft that saline is a negative contrast during TVS and is also useful in the distention of the uterus from