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Normal uterine cavity Malformations Fibroids Polyps Normal uterine cavity Hysterosalpingography (HSG): defines the size and shape of the uterine cavity and can reveal developmental anomalies or other acquired abnormalities. Low sensitivity (50%) and positive predictive value (PPV; 30%) in asymptomatic infertile women (Soares SR, Fertil Steril 2000) Ultrasonography (US) can be used to diagnose uterine pathology (Glatstein IZ, Fertil Steril 1998). Sonohysterography: defines the size and shape of the uterine cavity and has high PPV (>90%) and NPV for detection of intrauterine pathology (Schwarzler P, Ultrasound Obstet Gynecol 1998) Hysteroscopy: women should not be offered hysteroscopy as part of the initial investigation unless clinically indicated because the effectiveness of surgical treatment of uterine abnormalities on improving pregnancy rates has not been established. (NICE Guidelines). 38 35