Transvaginal sonographic evaluation at different menstrual cycle phases in diagnosis of uterine lesions

Intrauterine lesions (IULs) are a common finding in women of reproductive age,
particularly infertile women. Transvaginal sonography (TVS) is a popular tool for IUL detection,
but there are conflicting data with respect to its accuracy.
Methods: Five hundred and six women were enrolled into the study. Of these, 496 underwent
hysterosalpingography and subsequent TVS six different times during the course of their menstrual
cycle. If a lesion was detected, it was further evaluated by sonohysterography (SHG) and
hysteroscopy.
Results: Of 496 women, 41 were shown to have IULs by TVS and those lesions were confirmed
in 39 by SHG and hysteroscopy. All 39 lesions were detectable during the ovulatory and early
luteal phase (days 16–19) of the menstrual cycle. Accuracy of TVS during different phases was
largely dependent on the size of the lesion. TVS falsely detected two lesions and missed fine
adhesions in two patients.
Conclusion: Accuracy of TVS in detection of IULs is highly dependent on the menstrual cycle
phase, with the ovulatory and early luteal phase being the optimal time for this examination