Assessment of tubal patency in infertile women: can HyCoSy be performed in place of Hysterosalpingography?

Abstract

Objective: To determine the advantages and accuracy of hysterosalpingo-contrastsonography (HyCoSy) in the assessment of tubal patency with regards to conventional hysterosalpingography (HSG). Study design : Interventional study. Setting: The study was conducted at Lady Willingdon Hospital Lahore. Study Period: One year, from November 2003 to October 2004. Patients and methods: Thirty infertile women were examined with hysterosalpingo-contrastsonography (HyCoSy) using air and saline as contrast medium. The results were compared with those obtained from conventional hysterosalpingography.(HSG). Results: Altogether 30 patients were included in the study. They were examined with both HyCoSy and conventional hysterosalpingography (HSG) and the results were calculated. Of the patients investigated by salpingo -contrastsonography, 22 were found to have patent tubes whereas 8 were having blocked tubes. Unilaterality or bilaterality could not be detected by this method. Bilateral tubal patency was found by hysterosalpingography in 22 cases. Unilateral tubal patency was found in 5 cases. Bilateral tubal occlusion was detected in 3 cases using either technique .Sensitivity and specificity of HyCoSy was 90.9% and 89.4% respectively. Positive predictive value was 83.3% and negative predictive value was 55.55%. Conclusion: The outcome of the study shows that HyCoSy with the combination of air and saline is cost effective, reliable and safe method and can replace conventional hystero salpingography as base line investigation of infertility on out patient basis.