Reviewer’s report
Title: 
The effects of Saline Infusion Sonography on the histological quality of
endometrial sampling in women with postmenopausal bleeding
Version: 
1 
Date: 
10 Nov 2022
Reviewer's report:
I believe this paper evaluates a very important clinical question that often is
raised. After performing saline infusion sonohysterography when there is global
tissue can one immediately perform endometrial sampling with a suction piston
biopsy sampling instrument and be assured that one is getting reliable tissue.
This prospective, randomized, crossover type study very nicely demonstrates
that the histology performed after sonohysterography is, in fact, reliable. This
has important clinical ramifications. I found, however, the nomenclature to be
somewhat cumbersome and confusing. Especially their analysis of sufficient
versus insufficient tissue in Table 3 as well as its description in the text itself.
The purpose of the study is to compare parameters of sufficient to sufficient pre-
and post- SIS as well as insufficient to insufficient pre- and post- SIS. The
comparison of sufficient versus insufficient samples in general (Table 3) does
not belong in this paper and merely lengthens it and is somewhat confusing to
me as a reader. 
If the authors feel this is important clinical information, then perhaps a separate
report would be indicated.
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Is the study design appropriate to answer the research question (including the use
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