Comparison of hysterosalpingography and laparoscopy in evaluation of female infertility

Abstract

Background and Objectives: Laparoscopic surgery (LS) is the most important diagnostic technique for the detection of causes of infertility; however, this method is accompanied by some setbacks. Given the noninvasive nature and cost-effectiveness of hysterosalpingography (HSG), it is widely used as the first-line approach for the evaluation of the patency of the fallopian tubes and uterine anomalies in female infertility. Herein, we aimed to compare the diagnostic values of HSG with LS in the assessment of patency of the fallopian tubes and peritoneal disease in infertile women. Materials and Methods Results:The sensitivity, specificity, and accuracy of HSG for the detection of unilateral and bilateral tubal occlusion were 75%, 91.2%, 89.5%, 75%, 97.2%, and 96.6%, respectively. Furthermore, false-positive and false-negative rates of HSG for the detection of unilateral and bilateral tubal occlusion were 8.7% and 25%, respectively. The accuracy of HSG in detecting uterine anomalies and hydrosalpinx were 93.3% and 93.9%, respectively. Peritubal adhesion and TOA were detected in 61% of the cases with normal HSG. In addition, of the nine cases of bilateral tubal occlusion detected by HSG, six cases were confirmed to have bilateral occlusion using laparoscopy. The comparison between HSG and LS techniques showed a significant difference in diagnosis of distal fallopian tube occlusion (P=0.021) and unilateral fallopian tube occlusion (P<0.001) among infertile women. The comparison between HSG and LS techniques demonstrated a significant difference in diagnosis of TOA (P<0.001) and peritubal adhesion (P=0.033). Conclusion:It seems that the findings of HSG regarding occlusion, hydrosalpinx, and uterine anomalies are reliable. However, due to its low sensitivity in detecting peritubal adhesion, performing LS before initiation of treatment in these patients is necessary to rule out adhesion and to confirm tubal patency.

Diagnostic Efficiency and Reproducibility of Hysterosalpingography

“…We found 93% accuracy of HSG in tubal pathology diagnosis, similar results were reported by previous studies [16,17]. Lavy, et al [18] concluded that in 95% of patients with normal HSG or suspicious unilateral obstructed tube, laparoscopy is not indicated, and patient management will not be altered.…”

“…In agreement with the previous study [16], we found that the accuracy of HSG in the diagnosis of peri tubal adhesions was 84%.…”

Indication of Laparoscopy in Case of Tubal Infertility at the University Hospital of Brazzaville (Republic of Congo)

“…The HSG remains the first-line examination in the exploration of tubal infertility [7][8][9]. Its positive predictive value was 58.1%, superimposable to that reported by Bosteels [10].…”

Diagnostic accuracy of hysterosalpingography in comparison to laparoscopy to detect tubal occlusion in female infertility: An observational study

“…Infertility is a disease of couples due to failure to achieve clinical pregnancy even after 12 months of regular unprotected intercourse. 1 It may be primary or secondary. In primary infertility clinical pregnancy was never documented and secondary infertility refer to a couple where there was documented clinical pregnancy but failed to conceive subsequently.…”