Investigating on the diagnostic limitations of hysterosalpingography in tubal infertility

Abstract

Objectve To compared the standard diagnostic laparoscopy with the chromopertubation test, this study investigated the diagnostic value and its diagnostic of hysterosalpingography(HSG)in the assesment of tubal patency. Methods Form Jan.2005 to Dec.2009, 167 infertile patients in Sun Yat-sen Memorial Hospitalof Sun Yat-sen University were recruited, who had tubal diseases detected by hysterosalpingography and then received laparoscopic tubal re-examination.330 fallopian tubes were examined totally, the results of laparoscopy and hysterosalpingography for tubal patency assessment were compared retrospectively. Results There were statistical difference between the two methods. The positive coincidence rate (sensitivity) of HSG for detecting tubal patency was 55.0%, the diagnostic accordance rate of incompletely unobstructed tubes was 18.5%, and the negative consistent (specificity) of obstructed tubes was 84.4%. And the diagnostic accuracy was 71.8%. 148 Patients who had pelvic adhesion were detected by laparoscopy, however, only 30 cases of pelvic adhesion were detected by HSG. Conclusion HSG was an effective method for assessing tubal patency initially, but it had its own deficiency, it is necessary to make a diagnosis and give treatment under laparoscopy when tubal diseases were detected by HSG, especially when tubes were found to be incompletely unobstructed and the patients may have pelvic adhesion. Key words: Tubal patency; Limitations; Hysterosalpingography; Laparoscopy; Infertility