Comparison of Endometrial Cavity Volume on Hysterosalpingography with Uterine Volume and Endometrial Thickness on Ultrasonography in Cases of Infertility in Indian Women at a Tertiary Health Care Center

Infertility affects a substantial proportion of couples worldwide, with female factors, such as uterine and tubal abnormalities, contributing significantly to its burden. Transvaginal ultrasonography (TVUS) and hysterosalpingography (HSG) are routinely used in the evaluation of female infertility. This study was done to evaluate the correlation between endometrial cavity volume measured on hysterosalpingography (HSG) and uterine volume and endometrial thickness measured on transvaginal ultrasonography (TVUS) in infertile Indian women. A secondary objective was to determine the prevalence of uterine and fallopian tube abnormalities in this population. This descriptive observational study was conducted at a tertiary care center in Maharashtra, India, from July 2023 to December 2024. A total of 307 infertile women aged 18 to 45 years undergoing HSG were included. TVUS was performed prior to HSG to measure uterine dimensions, calculate uterine volume using the ellipsoid formula, and assess endometrial thickness. Endometrial cavity volume was calculated from HSG measurements using the same formula. Statistical analysis was performed to determine correlations between uterine volume, endometrial thickness, and endometrial cavity volume. The mean age of participants was 29.73 ± 4.89 years. Mean uterine volume, endometrial thickness, and endometrial cavity volume were 48.93 ± 37.15 mL, 6.10 ± 2.20 mm, and 4.57 ± 2.71 mL, respectively. A statistically significant positive correlation was observed between uterine volume and endometrial cavity volume (r = 0.372, p = 0.00001), uterine volume and endometrial thickness (r = 0.197, p = 0.001), and endometrial thickness and endometrial cavity volume (r = 0.152, p = 0.008). Abnormal uterine findings were identified in 30% of women, while tubal abnormalities were present in 75.9%. Peritubal adhesions were the most common tubal abnormality. TVUS was superior for detecting myometrial abnormalities such as fibroids and adenomyosis, whereas HSG was more effective in evaluating endometrial cavity morphology and tubal patency. A significant positive correlation exists between uterine volume measured on TVUS and endometrial cavity volume measured on HSG in infertile women. TVUS and HSG provide complementary information and together offer a comprehensive assessment of uterine and tubal factors contributing to female infertility.