**4.2. Office hysteroscopy versus saline-infusion sonography (SIS)**

In 1999, we published our first series of SIS for screening in infertile patients utilizing 0.9% saline as an infusion solution and Nelaton catheters for injection (39). We reported satisfactory results. One year later, we published a study (40) on the efficacy of SIS for the detection of endometrial polyps in comparison to the conventional hysteroscopy. These studies compared SIS versus conventional hysteroscopy with excellent results in favor of SIS. Later on, we introduced office hysteroscopy (I use it since 2002 utilizing 2.6 mm telescope). With the advent of vaginoscopic approach, the procedure gained more acceptability among our patients. Now, after these years of experience we changed our mind and strongly say that office hysteroscopy can easily replace indirect diagnostic tools like SIS or 4D ultrasonography. Moreover, more detailed description of the endometrial cavity particularly the blood vessels would be obtained only with office hysteroscopy as we recently published (41).
