The sensibility and specificity of 3D/4D HyCoSy to evaluate tubal patency in clinical setting

Abstract

Aim. The objective of this study was to evaluate the performance of 3D/4D hysterosalpingo-contrast sonography (HyCoSy) for the assessment of tubal permeability in the infertile patient. Methodology. Tridimensional HyCoSy was performed in a lot of 21 patients diagnosed with primary or secondary infertility, who were referred to our clinic for diagnostic laparoscopy between January and June 2019. Diluted SonoVue® was injected through a 6-8 Fr Foley catheter in the uterine cavity a day before the surgical act. The flow and the spillage of the contrast medium around ovary were recorded using 4D and 3D volumes, and the data were saved for later analysis. The sonographer and the surgical team were blinded regarding patients’ identity and the ultrasound results. The results and the duration of the procedures were noted and compared. Results. Thirty-nine salpinges were evaluated (three previous salpingectomies, two for ectopic pregnancy, one hydrosalpinx), and the overall accordance between 3D/4D HyCoSy and laparoscopic chromopertubation was 84.61%. The sensibility to identify a patent tube was 93.13% and the specificity was 60%. The positive and negative predictive values were 87.1% and 75%, respectively. Conclusions. Hysterosalpingo-contrast sonography using 3/4D acquisition and contrast software is a useful procedure to evaluate tubal patency.