Evaluation of Diagnostic Hysteroscopy as a Tool for Diagnosis of Tubal Factor of Infertility in Comparison to Diagnostic Laparoscopy

Abstract

Background: Fallopian tube obstruction is believed to play a role in 12-33% of subfertile couples. Therefore, the patency evaluation of fallopian tubes is a significant part of subfertile couple's work. Aim of the work: This work aims at comparing the sensitivity and specificity of the hysteroscopic assessment of tubal patency by the bubble test to diagnostic laparoscopy and hysterosalpingogram in infertile patients. Patients and Methods: A total of 100 women were recruited to the study during the period between January 2020 and June 2020. 100 patients underwent a diagnostic hysteroscopy followed by laparoscopy. Each Fallopian tube has been considered to be an individual case. Patency was evaluated in 200 Fallopian tubes. Results: A polyp was detected at three tubal orifice. Hyperemia was detected around two tubal orifice. Adhesions were detected at one tubal orifice. The tubes were patent in 113 cases with both methods. In 70 cases both laparoscopy and hysteroscopy found occluded tubes. The tubes were patent by laparoscopic dye in 10 cases, but could not be detected by hysteroscopy as such. Occlusion was observed by laparoscopy in 7 cases but patency was detected during hysteroscopy. Of the non-patent cases, 70 out of 77 laparoscopic findings were consistent with the hysteroscopic result, yielding a specificity estimate of 90.9% (95% CI 84.5% to 96.4%). Conclusion: Based on statistical analysis (sensitivity and specificity) of our data, diagnostic hysteroscopic bubble test is accurate and reliable compared to the laparoscopic test, which is considered a global standard criterion.

Hysteroscopic Evaluation of Tubal Patency Using Bubble Sign in Comparison to Diagnostic Laparoscopy

“…Hysteroscopy showed an overall accuracy of 91.5% [CI: 85.1%-97%] compared to laparoscopy. Consistent with our findings, Hefny et al [13] also reported a high level of agreement between the two methods of tube detection.…”

Comparison Between Hysteroscopic Proximal Tubal Occlusion Versus Laparoscopic Salpingectomy on Pregnancy Rates Following Intracytoplasmic Sperm Injection in Infertile Cases of Hydrosalpinx: Controlled Clinical Trial

“…Males are reported to be primarily responsible for 20-30% of infertility cases, although they also contribute to 50% of all cases. Secondary infertility is the most prevalent kind of female infertility, which is caused by infections in the reproductive system [3][4][5] . Female infertility represents approximately 65% of the overall causes for infertile couples.…”