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Abstract Background: Submucous fibroid, endometrial polyps, congenital uterine abnormalities and intrauterine adhesions are all potential causes of infertility. Distortion of uterine cavity by a fibroid or a septum can lead to implantation failure and recurrent early miscarriage. Traditionally, transvaginal ultrasound (TVUS) has been the first-line diagnostic tool for evaluating uterine diseases, also considering that gynecologists are familiar with the technique since it is included in the basic training in obstetrics and gynecology. Certainly, TVUS is an easy, fast and cheap method widely used. Objective: To evaluate the accuracy of 2D transvaginal ultrasonography (TVS) compared with hysteroscopy in diagnosis of intrauterine pathology in infertile women. Patients and Methods: This comparative prospective cohort study included 160 infertile women who had undergone transvaginal ultrasonography (TVS) compared with hysteroscopy in diagnosis of intrauterine pathology. The study was conducted in Ghamra Military hospital. Cases were included in the study during the period between February 2018 and Jun 2021. Results: our study reported that TVS had a misdiagnosis in 18 cases rate of 11.25 %. Ten patients were endometrial polyps, three were submucous fibroid, three were intrauterine adhesions and two were septate uterus. Conclusion: from this study, it is concluded that diagnostic hysteroscopy is superior to two-dimensional TVS in the diagnosis of intrauterine pathology. Diagnostic hysteroscopy gives more information than traditional two-dimensional TVS ultrasound. Hysteroscopy not only provides accurate visual assessment of the uterine cavity, but also provides a chance to treat any pathology detected during the examination. |