***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To compare the diagnostic accuracy and acceptability of transvaginal sonography ( TVS ) , saline infusion sonography ( SIS ) , and office hysteroscopy ( OHS ) for detecting intracavitary abnormalities in women with or without abnormal uterine bleeding ( AUB ) . DESIGN Prospect i ve double-blind study . SETTING Zekai Tahir Burak Women 's Health Education and Research Hospital , Gynecology Clinic ( Ankara , Turkey ) . PATIENT(S ) A total of 26 women with AUB and 24 women without AUB were enrolled in this study . INTERVENTION(S ) Transvaginal sonography , SIS , and OHS were performed on women scheduled for hysterectomy . MAIN OUTCOME MEASURE(S ) Sensitivity , specificity , and positive and negative predictive values of TVS , SIS , and OHS to detect intracavitary abnormalities ( with histopathologic findings used as the gold st and ard ) , duration of procedure , and pain scores . RESULT ( S ) The sensitivity and specificity of TVS , SIS , and OHS  in detecting intracavitary abnormalities were 56.3 % and 72 % , 81.3 % and 100 % , and 87.5 % and 100 % , respectively . The prevalence of endometrial polyps was not different in women with and without AUB . Saline infusion sonography was less painful than OHS ( pain scores of 4.3 and 7.2 , respectively ) . CONCLUSION ( S ) The diagnostic accuracy of SIS was equal to that of OHS in diagnosing intracavitary abnormalities . Moreover , SIS was less painful than OHS for patients We aim ed to compare the accuracy of transvaginal sonography ( TVS ) , saline infusion sonohysterography ( SIS ) and hysteroscopy ( HS ) for uterine pathologies among infertile women . A total of 346 patients were selected for  operative hysteroscopy , following SIS after TVS . SİS was performed with a Cook Soft 500 IVF catheter . Sensitivity , specificity , positive and negative predictive values ( PPV , NPV ) were calculated to compare the accuracy of TVS , SIS and hysteroscopy for uterine abnormalities . SIS showed a sensitivity of 87 % , specificity of 100 % and PPV of 100 % for endometrial hyperplasia , and a sensitivity and NPV of 100 % for polypoid lesions . For submucosal myoma SIS showed a sensitivity of 99 % with PPV of 96 % . Hysteroscopy had a sensitivity , specificity , PPV and NPV of 98 % , 83 % , 96 % and 91 % , respectively for overall uterine pathologies . Finally , SIS seems to be superior to TVS , for uterine pathologies , with respect to hysteroscopy as the gold st and ard BACKGROUND Hysterosonosalpingography as a contrast ultrasound method is safer , cheaper and easier to perform than hysterosalpingography in the assessment of the uterine cavity and fallopian tubes . Is it feasible for all patients ? Which is the main problem in the evaluation of target structures by ultrasound ? METHODS In a prospect i ve study , 68 patients in the initial stage of the infertility treatment were examined by hysterosonosalpingography using saline NaCl infundibile and Echovist as contrast media . Subsequently , further status of the tubes and uterine cavity was assessed by the " gold st and ards " , laparoscopy and hysteroscopy . RESULTS Sensitivity and specificity of hysterosonosalpingography using NaCl infundibile for evaluation of the uterine cavity was 100 and 88.8 % , respectively . Negative predictive value was 100 % and positive predictive value 97 % . Sensitivity and specificity of the method for the assessment of the tubal status was 100 and 66 % , respectively , negative predictive value was 100 % and positive predictive value was 61 % . For the assessment of tubal patency using positive contrast Echovist the method has shown 100 % sensibility and negative predictive value again but it reached a specificity of 77 % and a positive predictive value of 70 % . There were no evident complications during or after the procedure . CONCLUSION Hysterosonosalpingography is useful in making decisions regarding further procedures for the diagnosis and treatment of infertility . Uterine cavity evaluation using saline is the method of choice . Tubal patency can be assessed only under ideal sonographic conditions . The method is feasible for early assessment of the reproductive status of uterine cavity and fallopian tubes as a simple , safe and cheap outpatient method prior to any following invasive procedure or even histerosalpingography OBJECTIVE To compare the diagnostic accuracy , pain scores , and procedure length of outpatient hysteroscopy ( OHS ) , hysterosalpingography ( HSG ) , and saline infusion hysterosonography ( SIS ) for evaluation of the uterine cavity of infertile women . DESIGN Prospect i ve , r and omized , investigator-blind study . SETTING Tertiary infertility clinic . PATIENT(S ) Forty-six consecutive infertile women . INTERVENTION(S ) Outpatient HSG , OHS , and SIS , followed by operative hysteroscopy ( HS ) . MAIN OUTCOME MEASURE(S ) Uterine abnormalities , procedure length , and subjective pain . RESULT ( S ) Fifty-nine percent of infertile subjects were found to have an abnormality on at least one of three outpatient uterine evaluations . When compared with the case of definitive operative HS , 60 % of abnormalities were correctly classified by HSG , 72 % by OHS , and 52 % by SIS ( P : NS ) . When comparing all combinations of 2 outpatient screening tests to operative hysteroscopy , 68 % were correctly classified by HSG/OHS , 58 % by HSG/SIS , and 64 % by OHS/SIS ( P : NS ) . The average time length for the OHS was 9.1 min . , which was significantly greater than for both HSG ( average , 5.3 min ) and SIS ( average , 6.1 min . ) ( P<.0001 for both ) . HSG and SIS were not statistically different regarding procedure time length . The average pain score ( 0 - 10 ) for SIS was 2.7 , compared with 5.8 and 5.3 for HSG and OHS , respectively . Both HSG and OHS mean pain scores were significantly greater than the SIS mean . CONCLUSION ( S ) OHS , SIS , and HSG were statistically equivalent regarding evaluation of uterine cavity pathology in infertile women OBJECTIVES To compare the diagnostic accuracy of hysterosalpingography and sonohysterosalpingography in detecting tubal and uterine abnormalities . METHODS In a prospect i ve study for the evaluation of uterine and tubal pathologies , 186 patients with primary and secondary infertility rates ( 51.6 % and 44 % , respectively ) , as well as recurrent abortion rates ( 3.8 % ) , underwent sonohysterosalpingography .  The tubal pathologies , as well as intracavitary and /or structural uterine abnormalities , detected with this procedure were compared with preoperative hysterosalpingography and operative procedures . RESULTS With surgical findings as the gold st and ard , sonohysterosalpingography had a sensitivity of 78.2 % , a specificity of 93.1 % , a positive predictive value of 82.7 % , and a negative predictive value of 91 % . For total tubal and uterine pathologies , the findings for the same parameters using HSG were 76.3 % , 81.8 % , 90.9 % , and 59.2 % , respectively .  Sonohysterosalpingography  was more accurate than  hysterosalpingography  for detecting intrauterine adhesions and various forms of uterine anomalies . CONCLUSIONS Sonohysterosalpingography is a safe , easy , accurate , and promising procedure for the detection of female upper genital tract pathologies , especially because it can differentiate specific uterine anomalies This study was conducted to assess whether women would prefer to undergo  saline infusion sonography ( SIS ) or office hysteroscopy  for the investigation of the uterine cavity . In a r and omised controlled trial , 100 patients underwent SIS or office hysteroscopy for assessing patients ' pain scores . After the investigation , 92 of them were asked to fill out an anonymous question naire addressing their preference regarding the method of evaluation and treatment of the uterine cavity . A control group , consisting of 50 women who never underwent SIS or office hysteroscopy  , was also asked to complete an identical question naire . The question naire was completed by 113 women ( 83.7 % ) . Twenty-four ( 21.2 % ) women would opt for SIS , whereas 52 ( 46.0 % ) would opt for office  hysteroscopy  , and 37 ( 32.7 % ) had no preference . If therapy would be necessary , 48.7 % of the women would opt for an outpatient treatment , whereas 33.0 % of the women would prefer treatment under general anaesthesia . Despite the fact that SIS is less painful , the majority of the women prefer office hysteroscopy .  Additionally , therapy in an outpatient setting is preferred to a day case setting OBJECTIVE We conducted this prospect i ve study to evaluate saline contrast hysterosonography ( SCHS ) as a diagnostic modality for intrauterine lesions in comparison to hysteroscopy and endometrial biopsy . MATERIAL S AND METHODS We included 135 patients , of whom 70 presented with abnormal uterine bleeding and 65 with subfertility problems . All cases were examined with conventional transvaginal sonography and were further investigated with SCHS using saline as contrast medium , and finally hysteroscopy with endometrial biopsy that was used as the reference test . RESULTS SCHS revealed the presence of intrauterine pathology in 23 cases and failed in three ( 4.2 % ) . SCHS had a sensitivity of 94 % , a specificity of 71 % , a positive predictive value of 76 % and a negative predictive value of 95 % in the abnormal uterine group . In subfertile patients , SCHS revealed the presence of intrauterine pathology in 34 cases and had a sensitivity of 96 % , a specificity of 74 % , a positive predictive value of 79 % and a negative predictive value of 95 % . CONCLUSIONS We found that SCHS is an extremely accurate modality for the diagnosis of focal endometrial pathology , compared to diagnostic hysteroscopy OBJECTIVE To assess fecundity of infertile women after surgical correction of uterine septum .  DESIGN Prospect i ve controlled trial . SETTING Three academic infertility clinics . PATIENT(S ) Forty-four women affected by septate uterus and otherwise unexplained infertility represented the study group ( group A ) , and 132 women with unexplained infertility were enrolled as control subjects ( group B ) . INTERVENTION(S ) Hysteroscopic metroplasty was performed in group A , and group B was managed expectantly . All women were followed-up for 1 year without any other intervention . MAIN OUTCOME MEASURE(S ) Fecundity rate was calculated as the number of pregnancies per 100 person-months . RESULT ( S ) Pregnancy rate ( 38.6 % vs. 20.4 % ) and live birth rate ( 34.1 % and 18.9 % ) were significantly higher in group A than in group B. The survival analysis showed that the probability of a pregnancy in the twelve-months follow up was significantly higher in patients who had undergone metroplasty than in women with unexplained infertility . The corresponding fecundity ( 10-week pregnancy ) rates were 4.27 and 1.92 person-months in women who had undergone metroplasty and in women with unexplained infertility , respectively . CONCLUSION ( S ) Hysteroscopic resection of the septum improves fecundity of women with septate uterus and otherwise unexplained infertility . Patients with septate uterus and no other cause of sterility have a significantly higher probability of conceiving after removal of the septum than patients affected by idiopathic sterility OBJECTIVES The preliminary study was performed to evaluate the diagnostic accuracy of saline infusion sonohysterography ( SIS ) in the detection of intrauterine pathologies in infertile women The  SIS findings were compared to the results of two widely used procedures : transvaginal sonography ( TVS ) and hysteroscopy ( HS ) . MATERIAL AND METHODS 68 infertile women , aged 27 - 42 were enrolled in the study .  TVS , SIS and diagnostic HS were consecutively performed in every patient . The results of each method were compared . Sensitivity , specificity , positive predictive value and negative predictive values for TVS and  SIS  were obtained . RESULTS Intrauterine pathologies were diagnosed in 25 % of patients . TVS detected 6 ( 37.5 % ) and SIS revealed 11 ( 87.5 % ) of 13 intrauterine pathologies finally visualized at diagnostic hysteroscopy . TVS failed to visualize three submucous myomas , one endometrial polyp and two cases of septate uteri . All three cases of intrauterine synechiae were not detected with this method One submucous myoma and one endometrial polyp were not identified 
    Output:
    
CONCLUSIONS SIS is a highly sensitive investigative modality and comparable to the gold st and ard tool , hysteroscopy in the detection of intrauterine abnormalities in subfertile women .
SIS is a highly sensitive and specific test in the diagnosis of uterine polyps , submucous myomas , uterine anomalies and intrauterine adhesions and can be used as a screening tool for subfertile patients prior to IVF treatment